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A COPD Awareness Month Q&A With The COPD Foundation

Allison Inserro
Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death in the United States, and for COPD Awareness Month this November, The American Journal of Managed Care® conducted a Q&A with Jamie Sullivan, MPH, vice president of public policy and outcomes for The COPD Foundation, as well as Chief Medical Officer Byron M. Thomashow, MD. The COPD Foundation is a not-for-profit organization that works to improve the lives of patients with COPD.
AJMC®: What can be done to encourage an early diagnosis? 
Sullivan: Many of the early signs and symptoms of COPD are mistaken for normal signs of aging, being out of shape, or the effects of nagging respiratory infections and colds. People also self-treat these early signs by adapting their activity levels, slowing down, climbing fewer stairs, and taking over-the-counter medications. Often these early symptoms are not raised in regular medical encounters and the questions are not asked that get at identifying the symptoms so that proper screening can be initiated.

Greater public awareness that encourages people to report early signs and symptoms of COPD is one big step, but we need better ways to find COPD earlier in primary care settings. A major effort called CAPTURE is under way to validate a new process of screening for COPD that uses a questionnaire to identify people at risk and then utilizes electronic peak flow.  A full validation study is under way and there is great hope that this tool can support earlier diagnosis especially in primary care.

AJMC®:  Where are other gaps?
Sullivan:  Much has already been mentioned in the above answers. I would reference the National Action Plan for other ideas on high priority COPD strategies but, ultimately, we have a lot of work to do. We can work to reduce risk factors for COPD, increase awareness of early signs and symptoms, do better diagnosing COPD early and accurately, and ensure people with COPD get the best treatments that we have now. Meanwhile,  we have to strive to develop better treatments and we can do much better to ensure people with COPD are given the appropriate education and support that helps them live with the disease, rather than feel alone and hopeless as many do.

AJMC®: Is there anything you are particularly looking forward to in 2019 in COPD research news?
Thomashow: We are hopeful that the [National Institutes of Health] will make steps to initiate a Lung Health Cohort study that will focus on what factors protect young adults from environmental risk factors such as pollution and cigarette smoking. In addition, we hope that some of the output from the COPD Gene study may help us identify a broader group and additional phenotypes and endotypes of COPD. We also look forward to expanding the criteria and tools used to diagnosis and confirm COPD beyond spirometry and determining whether there is more about the role of peak inspiratory flow in selecting proper inhalers for our patients.

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