Care for COPD patients urgently needs optimization - innovative care models can provide relief
18.11.2021 12:39
COPD (Chronic Obstructive Pulmonary Disease) is a life-threatening and irreversible lung disease. Any acute deterioration (exacerbation) can have serious consequences for the patient's state of health and the associated quality of life. Therefore, exacerbation prevention is the goal of COPD therapy. However, current data from the AvoidEx study illustrate major deficits here. Innovative projects such as TELEMENTOR COPD could help optimize prophylactic management and save medical costs. On the occasion of World COPD Day on November 17, 2021, experts drew attention to the urgency of better care for COPD patients.
COPD is one of the major widespread diseases and, according to the World Health Organization (WHO), ranks third on the list of causes of death worldwide1. In Germany alone, around 7 million people2 live with this diagnosis. Therapy for COPD aims to prevent the progression of the disease, in particular to prevent and treat exacerbations (acute deterioration), complications and concomitant diseases, to alleviate the symptoms and to improve the general state of health
To improve patients.
Recognize exacerbations in a timely manner and intervene
“A COPD exacerbation is a serious case and is associated with numerous risks,” emphasizes Prof. Dr. Claus Franz Vogelmeier, Marburg. Recently published results of the retrospective observational study AvoidEx illustrate the importance of exacerbations in the care situation of COPD patients.3 Almost half (49.1 %) of the patients without exacerbations at the start of the study suffered at least one exacerbation during the follow-up -ups over 8 years.3 The analysis of data from more than 250,000 patients also shows that one or more exacerbations suffered increase the likelihood of further events and shorten the time until they occur. Every exacerbation increases the risk of hospitalization4 and mortality.5 Therefore, according to Prof. Vogelmeier, there is an urgent need for action because many COPD patients do not receive long-term drug therapy despite existing therapy options.6 So
The study results showed that almost two thirds of the patients examined had not received any of the guideline7 inhaled maintenance therapies in the 12 months before inclusion in the study.3 This also includes patients with severe and multiple exacerbations.3 This also applies to a third of the Patients with multiple moderate or severe exacerbations.3
Improved prevention of exacerbations through telemedicine
An innovative telemonitoring project that aims to improve outpatient care for people with COPD is “TELEMENTOR COPD – TELEMedicine moNiTORing for COPD patients”. The core of the telemedicine platform is an app that, in combination with appropriate measuring devices, enables continuous telemonitoring of certain vital parameters, such as breathing and heart rate. Practitioners can assess the patient’s state of health based on these measured values
If things worsen, intervene early. The project, funded by the Innovation Fund of the Federal Joint Committee (G-BA), in which numerous actors from patient care are involved, is led by Prof. Dr. Klaus F. Rabe, LungeClinic Grosshansdorf, and supported by AstraZeneca as a cooperation partner. “Our primary goal is to reduce the exacerbation rate and thus have a positive influence on the further course of the disease,” explains Prof. Rabe. Early interventions can also contribute to enormous cost savings because
Fewer COPD patients would need inpatient or emergency treatment and the use of other illness-related services would also be reduced.
Raise awareness of life-threatening lung disease
However, there are still many people for whom the disease COPD is almost unknown. World COPD Day is a reminder of how important healthy lungs are and what each individual can do to achieve this. “In everyday practice, I often encounter patients who are completely unaware of the significance of the diagnosis of COPD,” says Dr. Frank Kanniess, Reinfeld. More education and targeted information could increase awareness of COPD and help patients identify early
seek medical treatment.
In order to initiate appropriate therapy, a structured recording of the symptoms is essential. In order to promote the latter, the guideline group of the National Care Guideline for COPD has made an open recommendation for the use of the MEP questionnaire (Monitoring of Exacerbation Probability).7 This is intended to improve the detection of exacerbations. “Treatment of COPD must be consistent
and are regularly checked by a doctor,” says Dr. Kanniess. “Innovative digital tools can offer valuable support here.”
Speak Up – your voice for COPD
To raise further awareness of COPD, AstraZeneca has launched the “Speak Up – Your Voice for COPD” campaign. This calls on patients, doctors and public figures to raise their voices for COPD. The goal: to create more awareness of the disease, to educate people about the topic and to improve care. Further information about COPD can be found at:
https://www.copd.de/.
credentials
1 WHO, World Health Organization, https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death, (last accessed: November 12, 2021).
2 https://www.lungeninformationsdienst.de/krankenen/copd/verbreitung/index.html (last access: November 8th, 2021)
3 Vogelmeier CF et al. In J Chron Obstruct Pulmon Dis. 2021 2021;16:2407-2417.
4 Rothnie KJ et al. Am J Respir Crit Care Med. 2018;198:464-471.
5 Nigris E et al. P45 Mortality risk by exacerbation state in the ETHOS study. Thorax 2021:76:A109-
A110.
6 Make B. et al. Undertreatment of COPD: A Retrospective Analysis of US Managed Care and
Medicare Patients. Int. J. Chron. Obstruct. Pulmonary. Dis. 2012; 7:1-9.
7 Federal Medical Association (BÄK), National Association of Statutory Health Insurance Physicians (KBV), Working Group of
Scientific Medical Societies (AWMF). National care guidelines
COPD – Long Version, 2nd Edition, Consultation Version. 2020, available online at:
https://www.leitlinien.de/themen/copd (last access: November 14, 2021)
8 GOLD. Global Strategy for the Diagnosis, Management and Prevention of COPD, Global Initiative
for Chronic Obstructive Lung Disease (GOLD) 2021. Available online at:
https://goldcopd.org/wp-content/uploads/2020/11/GOLD-REPORT-2021-v1.1-25Nov20_WMV.pdf
(last accessed: November 12, 2021).
9 Adeloye D et al. J Glob Health. 2015;5:020415.
10 Lozano R et al. Lancet. 2012;380:2095-2128.