What is COPD?

COPD

Today, on World COPD Day, we are excited to share the results of the HOT-HMV trial presented at ERS, which show that HMV added to HOT can reduce by 51% the likelihood of readmissions to hospital or death over one year in hypercapnic COPD patients following an acute exacerbation of COPD.1 There are new prospects for better treatment of COPD—and better lives for patients.

copd

Seeing the bigger COPD picture

What is COPD?

Chronic obstructive pulmonary disease (COPD) is a group of progressive lung diseases typically characterised by chronic bronchitis and emphysema, which cause irreversible airflow limitation and inflammation in the airways.1

Although COPD is most commonly caused by long-term smoking, a substantive burden of the disease is due to occupational exposure to harmful agents, and genetic conditions such as congenital α1-antitrypsin deficiency.1

A global problem

COPD is not only a major health concern for governments and healthcare bodies, it’s also a leading contributor of disability and reduced quality of life in communities around the world. Often undiagnosed until chronic symptoms appear, the World Health Organization (WHO) estimates that right now, over 65 million people worldwide are living with moderate to severe COPD.3

Affecting individuals and families, COPD is often associated with tobacco smoking, but 1 in 5 patients diagnosed with COPD have never smoked.4,5

For patients who become hospitalised with acute exacerbations, close to 20% are readmitted within 30 days,6 with each hospitalisation placing a tremendous burden on patients and their families.

An economic problem

As the third leading cause of death worldwide, COPD is estimated to claim over 3 million lives globally every year. And as the population ages, this is expected to increase by 30% over the next decade.3

This growing number of patients creates heavy economic burdens. The annual cost on our healthcare system so far is already:

  • €38.6 billion in Europe1
  • $USD49.9 billion in the United States1
  • $AUD929 million in Australia.7

Given this significant impact, hospitals, insurance companies, care providers and patients are all looking for better solutions for the long-term care and management of COPD.

By understanding the problems caused by COPD and what ResMed’s intelligent non-invasive ventilation solutions can do, you can help create healthier communities and reduce the costs to healthcare.

COPD signs, symptoms and diagnosis

COPD progresses over time, and so its signs and symptoms depend on the stage of the disease. Common symptoms include:

  • Persistent cough
  • Chest tightness and breathlessness
  • Sputum production
  • Wheezing
  • Dyspnoea

The symptoms for COPD reflect those of its 2 main contributing conditions:

  1. Chronic bronchitis is a lasting inflammation of the airways characterised by excess sputum production and persistent cough.
  2. Emphysema is the destruction of lung tissue in the alveoli, which causes respiratory insufficiency.

The clinical diagnosis of COPD takes into account the patient’s medical history, a physical examination, diagnostic imaging and pulmonary function tests.1

The most objective standard to assess airflow limitation is spirometry, which includes measurements of the FEV1 (forced expiratory volume in one second) and the FEV/FVC (forced expiratory volume/forced vital capacity) ratio – the most indicative measures for COPD diagnosis.1

COPD stages

The severity of a patient’s COPD can be predicted using the Global Initiative for Chronic Obstructive Lung Disease (GOLD) Index,1 which is based on the patient’s pulmonary function.

Other COPD indices, such as the Body mass, Obstruction, Dyspnoea and Exercise capacity (BODE) index may also be used. The BODE Index uses a combination of patient assessments including BMI, FVC, FEV1, a 6-minute walk distance and a dyspnoea scale.2

COPD treatment and outcomes

Physicians treating patients with COPD often need to decide whether to continue using medication and rehabilitation alone, or whether to add non-invasive ventilation (NIV) to treatment which could improve the patient’s quality of life and slow COPD progression.

Find out which COPD patients can benefit from non-invasive ventilation.

References

1

Global Initiative for Chronic Obstructive Lung Disease (GOLD). “Global Strategy for the Diagnosis, Management and Prevention of COPD, 2015.” Goldcopd.com. http://www.goldcopd.org/uploads/users/files/GOLD_Report_2015_Sept2.pdf (accessed November 9, 2015)

2

Celli BR et al. The body-mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease. N Engl J Med. 2004;350:1005–12.

3

World Health Organization. “Chronic respiratory diseases: Burden of COPD” Who.int. http://www.who.int/gho/publications/world_health_statistics/en/ (accessed November 9, 2015)

4

Lamprecht B et al. COPD in Never Smokers. Chest 2011;139(4):752–763.

5

Eisner MD et al. An official American Thoracic Society public policy statement: Novel risk factors and the global burden of chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2010;182(5):693-718

6

Jencks SF et al. Rehospitalisations among patients in the Medicare fee-for-service program. New Engl J Med. 2009;360(14):1418-28.

7

Australian Institute of Health and Welfare. “COPD — chronic obstructive pulmonary disease: About COPD” Aihw.gov.au. http://www.aihw.gov.au/copd/ (accessed November 9, 2015)