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Strides and challenges

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Strides and challenges: a reality check on efforts to educate and empower COPD patients

COPD is a global health problem, and that other nations likely face similar, but also unique, challenges in patient engagement as well as in the delivery of medical care. A paper published in March 20181 in Respiratory Care details insights that help shed light on the industry’s efforts to educate and inform COPD patients. Interestingly, patients may be a bit over ambitious in terms of estimating just how well-informed they truly are about their condition. The team of physicians authoring the paper ultimately suggests a focus on robust and sustained education and support for COPD patients. The paper is informed by surveying 240+ US patients, aged 40 and older, who have been diagnosed with COPD, chronic bronchitis, or emphysema.

Knowledge is power

The survey1 suggests a gap between what patients claim to know about COPD and what they actually may know. Most surveyed claim to understand the disease and available treatments, but less than half indicated they understood what causes COPD and the typical symptoms.

Patient COPD knowledge

only

45%

knew the typical symptoms

only

44%

claimed to know the cause of COPD

only

35%

were knowledgeable about medications used to treat and manage exacerbations

only

27%

were aware of the importance of preventing their COPD symptoms (COPD exacerbations)

However, the study does suggest that some educational efforts may have worked. Many subjects claimed that they understand the risk factors associated with COPD.

COPD education effectiveness

only

93%

cited cigarette smoking as major risk

only

77%

cited secondhand smoke 

only

74%

recognized environmental exposure at work

only

72%

identified indoor air pollution

Office visits

While most subjects are informed about the risks of COPD, the study suggests a need for more robust patient education during office visits with a care professional. Less than half recalled discussing smoking cessation and treatment options during an initial visit.  Only 43% recalled COPD management and prevention of risk as being discussed. In terms of therapy, 47% recalled being trained on how to use an inhalation device, with few recalling any discussions around how to clean them. A mere 7% of subjects stated that proper use of their treatment device was a topic of discussion in more than half of the visits with their physicians. Additionally, 9% stated that such a discussion occurred at each visit.

 

In general, many did not feel that their initial appointment was long enough to cover all the ground it needed to. 25% felt there was not enough time during the visit to cover all of their questions. Although patient recall may be a factor, the authors suggest more information sharing may be needed during visits.

Events

Philips attends the American Thoracic Society Conference 2018

May 19-24 in San Diego

A recap of the event will be made available in an upcoming newsletter issue.

 

Poster sessions:

  • “Modulators Of Nocturnal Hypoxemia In Patients With Heart Failure And/or COPD - A Multicentre Retrospective Analysis.” May 20 @ 9:15 AM
  • “Cost-Effectiveness of HOT-HMV for Treatment of COPD.” May 20 @ 2:15 PM
  • “ASV Meta-analysis” by Dr. Sai Parthasarathy. May 21
  • “Sleep-related Breathing Disorders Are Not Associated With Elevated Daytime Sleepiness In Patients With Chronic Obstructive Pulmonary Disease And/or Systolic Heart Failure.” May 22 @ 9:15 AM

Takeaways

Philips recently sponsored a symposium conducted by touchRespiratory at the JVID conference in Lyon, France: New Non-invasive COPD Screening of EFL Within Home Therapy

 

Explore clinical insights around expiratory flow limitation.

 

View video interviews of leading respiratory experts made possible by a grant from Philips.

Whom do patients rely on?

Patients rely on their care provides – when it comes to therapy. The survey suggests that most believe that health care professionals are responsible for assessing and training them on the proper use of inhalation devices.

COPD care provider insight doctor icon

32%

believed physicians are mainly responsible for assessing proper technique 

COPD care provider insight person with cross icon

26%

believed nurses bear the primary responsible 

COPD care provider insight professional icon

7%

believed pharmacists were responsible

COPD care provider insight people icon

28%

believed that no single provider was responsible for assessing technique and training on inhalation devices

What do patients rely on?

Therapy devices is considered essential to successful COPD management. 54% of patients had used small-volume nebulizer (SVN). Of those who used it, the device scored highly in terms of key preference metrics:

Considered it infographics

Perhaps of little surprise then, SVN’s were preferred by 54% over other devices by patients who had used them. Additionally, In terms of overall device therapy effectiveness, the authors suggest that less than optimal patient–physician interactions during office visits also contribute to inhaler misuse or poor adherence.

Who am I?

The survey captures common attributes of the COPD patients which tended to mirror the overall population in the United States:

 

  • Mostly Caucasian
  • App 50-/50 split between male and female
  • Ages: 50-70 typically
  • Most retired, but 20% cannot work due to impact of COPD
  • Multiple comorbid conditions:  hypertension (57%), depression & asthma (31%), anxiety (30%), heartburn (27%), Diabetes (27%), sleep apnea (26%)

Learn more about the state of COPD patient education.

(May require subscription to Respiratory Care)

About the survey: A multiple-choice online survey, developed by a steering committee of American Thoracic Society clinicians and scientists. Article published in RESPIRATORY CARE Paper in Press. Published on March 20, 2018 as DOI: 10.4187/respcare.05715 .Authors : Rajiv Dhand MD, Donald A Mahler MD, Brian Carlin MD, Nicola Hanania MD MSc ,Jill Ohar MD, Victor Pinto-Plata MD MSc, Tina Shah MD MPH, David Eubanks EdD RRT, and Sidney S Braman MD.

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