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The COPD National Action Plan: Goal 2

Posted on March 29, 2016   |   
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Thank you for your comments on our Town Hall Goal #1 post! Your feedback is important to us and this community as we take our collective next steps.

patient innovations

This week we will focus on Goal #2 of the National COPD Action Plan: Increase and sustain prevention, detection, diagnosis, treatment, and management of COPD.

This is a broad and important goal, so please feel free to comment on all or parts of this objective. How can we all work to increase and sustain these efforts or implement new and innovative approaches?

In thinking through these goals, it may also help to expand upon a few terms.

  • Prevention: Prevention is stopping the development of a disease or its comorbidities and can also include the prevention of additional symptoms. These might be educational efforts to reduce smoking and exposure to other lung irritants or prevention of disease through influenza or pneumococcal vaccines. What do you think we should be doing in the area of prevention?
  • Detection: Detection and diagnosis are easily confused terms. Detection is the initial identification of issues or symptoms; in the case of COPD, it might be dyspnea or increased mucous production. The person experiencing these symptoms and his or her provider do not yet know what is causing these issues as the diagnostic process has not yet been initiated. What are your thoughts on improving detection?
  • Diagnosis: Diagnosis is a more formal and systematic identification of an actual disease or disorder. In COPD, the diagnostic gold standard is spirometry. (See our expanded page on diagnosis here.) How can we improve the diagnosis of COPD and its comorbidities?
  • Treatment: Next up is treatment. Treatment here refers to addressing the underlying cause of a disease and its symptoms. In the case of COPD, it could be a surgery, medication or non-pharmaceutical intervention, such as pulmonary rehabilitation. For patients, it could also be personalized education and tools that promote shared decision making. For providers, it could include the distribution of and education on evidence-based guidelines. This is a broad and important task. How can we improve treatment and issues associated with it, such as access to treatments?
  • oxygen cannula
  • Management: Management of a disease and its comorbidities is a more global concept that includes not only treatment of the disease itself, but extends to the whole patient and his or her presentation – including addressing the psychosocial aspects of living with a chronic disease, activities of daily living and the empowerment of the patient to self-manage his or her disease. How can we improve or sustain our efforts in this area?

No matter if you are a patient or provider, family or community member, we look forward to your ideas on Goal #2 – how can we increase and sustain prevention, detection, diagnosis, treatment, and management of COPD?


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  • We need to work with primary care and family docs and providers, to give them ongoing education and resources about detection, diagnosis and treatment, as they are often the first folks who see people with the earliest stages of COPD.

    Smoking cessation tobacco treatment specialists should also be educated about detection of COPD and share that info with their clients.

    Sadly, there is still a lot of nihilism in treating patients with COPD at many institutions. Many providers accept as inevitable a fairly rapid progression of COPD and not much relief in symptoms via treatments.
    • We also need to get CMS to fix the DME reimbursements and O2 devices available so that patients can get the portable O2 they need to remain active and exercise, so they can remain productive members of society and continue working and doing all they are physically able to do.
  • I can see this needs to be a dual action plan. We do need to get out information on smoking cessation for sure. This will cute the rate considerably of new patients down the road. We also need to do the things that HIcopd (thank you Hlcopd) has proposed to catch the other high percentage of yet identified COPD patients out there.
    How do we get to all Insurance Companies and discuss the need for this to get early treatment at a fair cost, thereby saving the cost of hospitalizations down the road? I would love to see the all the providers come together with along with CMS ( for the medicare and medicaid users) and actually listen to the newest treatments that need to be OK'd.
    So many treatments work. The best and easiest is rehab and exercise! Having been through it long ago, even now there are new and better options at rehab. To have that connection and know the as a patient you are responsible to do the work is a great start. We just need to know that each person is able to actually "get to the rehab center", have a" trained specialist" there and that we can "actually afford" it and above all have the "O2 resources" needed to do all that. That would be a wonderful start.

  • As I watched the live stream of the Town Hall meeting, I kept reflecting on the difference in money spent on funding/research/prevention/awareness between COPD and other diseases, specifically heart disease, some cancers and HIV/AIDS. It occurs to me that studying what the advocates for these diseases did to tackle some of these goals might help inform an approach for COPD.

    Obviously there will be differences, but perhaps some interesting similarities too. For example, HIV/AIDS could have been pushed aside due to the initial stigma of patient lifestyles, but it didn't. Why is that? The progression of heart disease can often be slowed if caught early (via measurements for hypertension or hyperlipidemia) and those protocols have become well known and utilized. How did that happen?

    These are just a couple of examples of things than might be learned and applied from studying national activity taken on prevention, detection, diagnosis, treatment and management of other major diseases.
    • Great point Merry! We do indeed have a lot to learn from others as we try to engage the community to speak out on these important issues. I have been doing a bit of searching and hope to meet with a few groups that spearheaded some of the efforts and maybe we can put together some future blogs to share the info and get feedback on how we can learn from them and how we have to tweak some of what they did. I would welcome your feedback along the way!
    • Jamie, I look forward to seeing what you come up with!
  • Thanks everyone -- keep the comments coming! I am gathering them and will ensure the policy group has your feedback when the draft plan is sent to us. All your points are important so please share.
  • Education for healthcare providers especially on the importance of doing spirometry testing to diagnose correctly. National COPD standards of care much like CMS did with heart failure, Pneumonia, Acute MI core measures which are mandated and tied to reimbursement like our other VBP programs. That way every patient gets evidenced based care. Greater smoking cessation campaigns for all ages as well as avoidance of second hand smoke and other air pollutants that can damage lungs.
  • I believe that intervention and exercise early on is the key to a better quality of life down the long road of COPD.
    There used to be a machine called a BIRD respirator that the inspired tidal volume could be adjusted so that it delivered a set tidal volume . If your capacity was 700 ml it would stop after delivering 700 ml. People with COPD have decreased tidal volumes and over time starting low and avoiding barotrauma it would be lung exercise without taxing the rest of the system. A fancy incentive spirometry with the emphasis being tidal volumes and not the pull needed to move the goofy balls.

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