RESPIRATORY DISEASE CRISIS LOOMING
Cost of COPD is $1.67 billion per year in Canada
SASKATOON, November 17--Chronic obstructive pulmonary disease (COPD) is one of the few leading causes of death on the rise, and by 2020 is expected to be the third leading cause of death worldwide.1 New COPD guidelines, developed by The Lung Association's medical section, the Canadian Thoracic Society (CTS), aim to slow the progression of this fatal lung disease by optimizing early diagnosis, prevention and management 2.
COPD is the fourth most common cause of hospitalization among men and the sixth most common cause of hospitalization among women in Canada 3.Â In 2000, the average hospital stay for a COPD patient was nine days, and there are currently 60,000 Canadians hospitalized with COPD each year.Â This figure is estimated to double by 2016 3.Â The economic burden for COPD in Canada is enormous, costing $1.67 billion in 1998, and this figure is growing every year 4 .
COPD patients require a significant amount of medical care and attention over an extended period of time, says Dr. Darcy Marciniuk, researcher and COPD Professor with the University of Saskatchewan and CTS COPD Guideline Development Committee.Â This disease not only places a tremendous physical and emotional toll on patients, but it also has an enormous impact on healthcare costs. However, COPD is a preventable and treatable disease.
The goals of managing COPD are to prevent disease progression, reduce and alleviate breathlessness and other respiratory symptoms, improve exercise tolerance, prevent and treat flare-ups, and reduce mortality.
The COPD guidelines, introduced in June 2003, recommend a stepwise approach to management, based on severity of symptoms and disability.Â Key recommendations include:Â smoking cessation and education that incorporates a self-management plan offered to all patients; bronchodilator therapy should be prescribed to achieve maximum symptom control and some patients may benefit from the addition of inhaled corticosteroids (ICSs); it is also imperative that patients be encouraged to engage in regular exercise so as to avoid deconditioning.Â In addition, enrolment in a supervised pulmonary rehabilitation program is preferred and strongly advocated for all patients.Â Supplemental oxygen and surgery are reserved for consideration in patients with advanced stages of the disease.
Family physicians have a primary role in the management of COPD, says Dr. Darcy Marciniuk.Â Despite its prevalence, most patients are not diagnosed until the disease is well advanced and quality of life is severely impacted.Â With the development of the COPD Guidelines, we now have a standardized approach to address the management and treatment of COPD.Â The goal is to slow the progression of the disease and help patients live as full a life as possible.
The full executive summary of the Canadian Thoracic Society recommendations for management of chronic obstructive pulmonary disease “ 2003 can be found at www.pulsus.com under the Canadian Respiratory Journal, May/June 2003 Issue.
COPD is a respiratory disorder largely caused by smoking, and is characterized by progressive, partially reversible airway obstruction, systemic manifestations and increasing frequency and severity of exacerbations.Â Systemic effects of COPD include:Â peripheral muscle dysfunction; right heart failure; polycythemia; change in nutritional status; and depression.Â These symptoms, together with respiratory impairment, contribute to a poor quality of life 3.Â Themost common form of COPD is a combination of chronic bronchitis and emphysema.
In Canada, an estimated 500,000 people over the age of 35 have been diagnosed with COPD and an almost equal number of middle-aged Canadians may also have COPD, but are not aware of it.5
A recent Ipsos Reid survey found that awareness of COPD is very low in spite of the fact it is the fourth leading cause of death in Canada and the only leading cause rising in prevalence. Only eight percent of Canadians are aware of what COPD is. 6 COPD awareness is highest in BC (10 per cent awareness) and Atlantic Canada (15 per cent awareness), lowest in Alberta (3 per cent awareness), and much higher among women (11 per cent awareness) than men (4 per cent awareness).
World COPD Day
On November 19, World COPD Day, The Lung Association and its medical section, the Canadian Thoracic Society (CTS), join a worldwide coalition of medical professionals called the Global Initiative for the treatment of Chronic Obstructive Pulmonary Disease (GOLD), healthcare associations, patient groups, and government organizations in raising awareness about one of the world's leading, and least known diseases.
The Lung Association
The Lung Association is a registeredÂ charity that providesÂ lung healthÂ education andÂ programs,Â and fundsÂ for researchÂ to improveÂ theÂ lung healthÂ of all Canadians.Â Â We focus on the prevention and control of lung diseases such as asthma, COPD, sleep apnea as well as offering help in the area of tobacco prevention,Â cessationÂ andÂ air quality. For further information, call The Lung Association at 1-888-566-5864 (LUNG) or visit our website at www.lung.ca.
The Canadian Thoracic Society (CTS) is the Association's medical section, and advises the Association on scientific matters and programs including policies regarding support for research and professional education.
For more information about COPD diagnosis, treatment, and management, contact
The Lung Association's BreathWorksâ„¢ Program, an initiative designed to help patients, and their families and caregivers, cope with the emotional hurdles and physical challenges of living with COPD.Â Call the toll-free BreathWorksâ„¢ Helpline at 1-866-717-COPD (2673) or visit the web site at www.lung.ca/breathworks.Â Information and materials are free to healthcare professionals.
For additional information about this news release, or to arrange an interview with a physician, please contact:
- Murray CJ, Lopez AD. Alternative projections of mortality and disability by cause 1990-2020; Global Burden of Disease Study. Lancet 1997; 349; 1498-504.
- Executive Summary. Canadian Thoracic Society recommendations for management of chronic obstructive pulmonary disease 2003. Can Respir J 2003:10 (Suppl A): 5A-32A.
- Centre for Chronic Disease Prevention and Control. Editorial Board for Respiratory Disease in Canada, Health Canada, Ottawa, Canada, 2001.2.
- Economic Burden of Illness in Canada 1998. Health Canada, Ottawa, Canada, 2002.
- Ernst PP, Bourbeau J, Rainville B, Benayoun S, Suissa S. Underestimation of COPD as a cause of death. Eur Respir J 2000; 16 (Suppl. 31) :13s.
- Ipsos-Reid survey.Â These results are from a survey of 1055 Canadian Adults (age 18+), conducted by Ipsos-Reid between October 24 and October 30 2003.Â In a sample of this size, the margin of error can generally be considered to be +/- 3%, 19/20 times.