Study Finds That Many Ignore Symptoms of COPD

While Americans’ awareness of chronic obstructive pulmonary disease (COPD) continues to rise, many of those at risk don’t talk to their doctor about symptoms. That is according to a recent survey conducted by the U.S. National Heart, Lung, and Blood Institute (NHLBI).

“COPD is surpassing other diseases as a major killer in this country. We want to reverse this trend by educating people about the symptoms, so they can get proper treatment as early as possible,” said James P. Kiley, Ph.D., director of the NHLBI Division of Lung Diseases, in a press release from the organization.

COPD affects 24 million people in the United States, yet as many as half of them have not been diagnosed. The third-leading cause of death in the U.S., COPD causes shortness of breath, chronic coughing or wheezing, excess sputum production and a feeling of not being able to take a deep breath.

According to the survey of almost 4,200 adults, 71 percent of respondents said that they are aware of COPD, compared with 65 percent in 2008. Awareness among those most at risk – current and former smokers – increased even more. Among current smokers, awareness rose to 78 percent, up from 69 percent in 2008. Awareness among former smokers rose to 76 percent, up from 68 percent in 2008.

The survey also found that 27 percent of current smokers said they had suffered from a chronic cough or wheezing or had been too short of breath to do normal activities in the past year. That’s more than double the rate in the general population (13 percent). However, 40 percent of smokers who said they had these COPD symptoms had not discussed them with a doctor or other healthcare provider.

Said Kiley, “It is not enough to have heard of COPD. Those at risk need to know the signs so they can talk to their healthcare provider about any breathing problems they are having and, hopefully, find relief.”

Online Tool Allows Patients to Better Manage Chronic Illnesses

Individuals suffering from chronic illnesses, such as heart disease, asthma, arthritis, diabetes, bronchitis or emphysema, now have an online resource to help them learn how to better manage their disease and improve their health. The tool, Better Choices, Better Health™, is being offered free of charge by OASIS, a national education organization dedicated to enriching the lives of adults age 50 and older through health and wellness, education and enrichment programs.

Better Choices, Better Health is an online version of the internationally recognized Chronic Disease Self-Management Program (CDSMP), developed and tested at the Stanford University Patient Education Research Center. The six-week online workshop provides users with information on a broad range of topics, from an overview of self-management and chronic health conditions to action plans, how to deal with emotions, depression and fatigue, exercise and nutrition, medication management and how to work with healthcare professionals.

To complete the workshop, participants must log on to the website for two hours each week and complete readings and interactive learning exercises via the Better Choices, Better Health Learning Center. Included in the interactive learning plan are weekly action plans, problem solving and guided online exercises and other self-tests and activities. Participants are also encouraged to post their disease-related problems on the website’s bulletin board and help other group members with problems they encounter.

Trained peer facilitators moderate each workshop. They are available to facilitate discussions, monitor participation, answer questions, assist program participants with problem solving and ensure that individuals who are seeking specific medical advice turn to their healthcare provider.

For those individuals without Internet access or who prefer to attend a workshop in person, OASIS also offers a classroom version of the class, Living a Healthy Life.

For more information or to register for either of the OASIS programs, visit www.oasisnet.org/betterchoices.

Dust Storms Increase Emergency Hospital Admissions for COPD Patients

Dust storms have an adverse effect on emergency hospital admissions for people suffering from chronic obstructive pulmonary disease (COPD), according to a recent study out of China.

The study, which was published in the journal Respirology, was lead by professor T.W. Wong, MBBS, MSc, FFPH, of The Chinese University of Hong Kong. Wong and his colleagues studied data on daily emergency admissions to major hospitals in Hong Kong for respiratory diseases, as well as indices of air pollutants and meteorological variables from January 1998 to December 2002.

The researchers identified five dust storms during the period and made comparisons to the daily emergency admissions for respiratory diseases using independent analysis. Results showed that significant increases in emergency hospital admissions due to COPD were found two days after an identified dust storm.

The researchers believe that this suggests that the coarse particles encountered during dust storms have an adverse affect on lung health, particularly in patients with COPD.

Dust storms in East Asia and South China are caused by wind-blown dust that travels long distances from North China. The concentrations of coarse particles — those with a diameter ranging from 2.5 micrometers to 10 micrometers — can reach very high levels.

“Our findings show a need for timely warning for patients with chronic lung diseases to avoid exposure to air pollution when a dust storm is imminent,” said researcher Wilson W.S. Tam.

COPD: The Basics

Chronic obstructive pulmonary disease (COPD) is the third-leading cause of death in the United States and one of the most common lung diseases in the world. According to the World Health Organization (WHO), nearly 210 million people across the world are currently suffering from COPD. That estimate includes nearly 12 million Americans living with COPD, while another 12 million may be left undiagnosed.

COPD is a combination of diseases, with most patients suffering from both chronic bronchitis and emphysema, making breathing more and more difficult for them. That is because emphysema destroys the air sacs in the lungs over time, reducing the surface area of the lungs and the amount of oxygen that enters the bloodstream. Further, chronic bronchitis leaves patients with inflamed bronchial tubes and a long-term cough with mucus.

Symptoms of COPD include shortness of breath, coughing with or without mucus, respiratory infections, tightness of the chest, wheezing and trouble catching one’s breath. However, most COPD patients do not experience symptoms from the disease until their lungs have been severely damaged, making it important for those people who are at risk for the disease to be screened regularly. Spirometry is the most commonly used test for diagnosing COPD, while X-rays, CT scans and lab tests can also be used.

While smoking is the main cause of COPD, inhaling irritants such as chemicals, dust and other fumes are also risk factors. COPD can also affect those who have never smoked or had any contact with harmful pollutants, as there is a genetic risk factor for developing emphysema. The most commonly known genetic risk factor for emphysema is called alpha-1 antitrypsin (AAT) deficiency, which leaves patients with little to no AAT protein in the bloodstream. This deficiency leaves room for white blood cells to damage the lungs. While AAT deficiency seems to be the main cause of COPD among nonsmokers, researchers believe that there are other genetic factors that may increase the risk of developing the disease.

While currently there is no cure for COPD, there are treatment options to relieve symptoms and keep the disease from progressing. These include medications such as inhalers and steroids, oxygen therapy, pulmonary rehabilitation and surgery. There are also steps that COPD patients can take on their own to improve their symptoms, including:

• Practicing controlled breathing and relaxation exercises
• Exercising regularly to strengthen respiratory muscles
• Maintaining a healthy diet and drinking plenty of water
• Avoiding crowds and cold air
• Getting vaccinated for respiratory infections
• Quitting smoking and avoiding places where smoking is permitted

While COPD cannot be cured, it can be prevented by avoiding smoking and by breathing clean, fresh air to keep lungs healthy.

Click Here to Access More Information About COPD From dailyRx.

Genetic Condition May Be Undiagnosed in COPD Patients

Hundreds of people suffering from chronic obstructive pulmonary disease (COPD) may have yet to be diagnosed with a genetic condition that causes severe hereditary emphysema, according to a recent study published in Respiratory Research.

The study, which was conducted by the Royal College of Surgeons in Ireland (RCSI), Beaumont Hospital and Trinity College Dublin, found that Ireland has one of the highest incidences in the world of this inherited condition known as alpha-1 antitrypsin deficiency (alpha-1).

The root of the most severe form of hereditary emphysema, alpha-1 is caused by a deficiency in alpha-1 antitrypsin, which protects the lungs from the harmful effects of cigarette smoke and bacterial infection. Patients diagnosed with alpha-1 typically develop COPD in their 40s and 50s and are prone to liver disease.

Thought to be a rare disease, alpha-1 is much more common than expected in Ireland, with one in 25 individuals found to be carriers, according to the study. These findings make alpha-1 the most common fatal inherited lung condition in Ireland after cystic fibrosis.

In its most severe form, alpha-1 is estimated to affect more than 2,000 people nationally, while 10,000 individuals are at increased risk for a less severe form of the condition and 170,000 individuals are carriers and may be at risk of developing lung disease, particularly if they smoke.

“Our study shows the prevalence of alpha-1 in Ireland is among the highest in the world and although a simple blood test is all that is required to diagnose this condition, over 90 percent of alpha-1 individuals remain undiagnosed,” said Gerry McElvaney, Professor of Medicine at the RCSI and senior author on the research in a recent article from the Irish Medical Times. “The importance of an early diagnosis of alpha-1 cannot be overstated, as the proper medical follow-up and lifestyle changes can help prevent or at least delay the development of lung and liver disease associated with this condition and greatly increase life expectancy.”

McElvaney and colleagues hope that the findings of this study will lead to increased awareness of the disease and earlier diagnosis.

Click Here to Access the Study from Respiratory Research

Early Detection of COPD Instrumental in Lung Cancer Diagnosis

While it is well-known that chronic obstructive pulmonary disease (COPD) is a significant risk factor for lung cancer, with approximately 1% of COPD patients developing the cancer each year, a recent study has shown that the early detection of COPD is instrumental in picking up more cases of lung cancer in COPD patients.

The study, which was published in the European Respiratory Journal, found that patients with COPD had a fivefold increased risk of developing lung cancer. Researchers discovered this increased risk through a review of medical evidence, with findings sufficient to justify CT screening for lung cancer among those diagnosed with COPD.

While low-dose computed tomography (LDCT) is an effective procedure for the early detection of lung cancer in high-risk patients, determining which patients should be screened for the cancer in a primary care setting is difficult. However, researchers now believe that patients who have been diagnosed with COPD should be screened by CT scan to detect lung cancer at an early stage. Further, the lung function of former and active smokers should be routinely tested to help identify COPD at an early stage.

Researchers propose that for the prevention of both diseases, COPD screening in smokers should be initiated as early as possible, so that they can stop smoking and candidates for an efficient lung cancer screening program can be identified.

“Both COPD and lung cancer have high mortality rates and a serious economic impact worldwide,” said study leader Yasuo Sekine, an associate profession at Tokyo Women’s Medical University. “The findings from our analysis suggest that early detection of COPD in addition to lung cancer screening for these patients could be an effective detection technique for lung cancer.”

Click Here to Access the Study from the European Respiratory Journal