Call for global COPD education shakeup

Aug 30 2013

Researchers behind a global survey of chronic obstructive pulmonary disease (COPD) patients say that more must be done to educate patients about the disease and what to do during exacerbations.

The team, led by Neil Barnes from the London Chest Hospital, UK, surveyed patients from 14 countries and found that many seemed to have low expectations around disease control and were unaware of the importance of responding quickly to exacerbations.

Furthermore, the study highlighted the impact of COPD on patient quality of life, with many reporting they took a limited outlook on the future and feared the illness would curtail their life expectancy.

“By highlighting the fears and concerns of COPD patients, many of whom are of working age with financial and familial responsibilities, the survey draws attention to the need for better patient education regarding the severity of the disease, the importance of prompt treatment of exacerbations, and the treatment and lifestyle options available,” Barnes and team write in BMC Pulmonary Medicine.

Their study involved survey responses from 2000 patients with COPD, chronic bronchitis, and/or emphysema, who were categorized according to Medical Research Council (MRC) breathlessness score: 1231 (62%) were grades 1 or 2 and 769 (38%) were grades 3–5.

The team found that despite heavy healthcare use during the preceding 12 months, 69% of patients thought that their COPD was well-controlled.

“This type of mismatch is not unusual, and has been widely reported in studies of both COPD and asthma patients, suggesting low levels of expectation,” the authors comment.

Overall, 62% of patients in MRC 1 or 2 grades and 80% of patients in MRC grades 3 to 5 had experienced an exacerbation in the previous 12 months, with 52% of patients in the latter group requiring hospitalization.

However, 27% of patients did not contact their healthcare service during exacerbation, taking actions such as cutting down on smoking, resting, or increasing medication dosage instead. And, less than 60% said that they would take immediate action in response to an exacerbation.

Patients reported that COPD and exacerbations affected their quality of life and their ability to commit to future events, with 77% worried about their long-term health. Additionally, 38% of MRC 1 and 2 patients said they feared premature death due to COPD, as did 59% of MRC 3 to 5 patients.

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