Why don’t people with COPD get all the treatment they need?
Sixteen million people in the U.S. have been diagnosed with chronic obstructive pulmonary disease (COPD). Millions more have it but have not been diagnosed. Chronic respiratory diseases, primarily COPD, are the country’s fourth-leading cause of death – and third-leading among chronic diseases, just behind heart disease and cancer.
Even more shocking is that few patients use pulmonary rehabilitation, a treatment proven to reduce symptoms and enhance their quality of life. In fact, a recent study published in the Annals of the American Thoracic Society showed that only 1.9 percent of patients hospitalized for COPD received pulmonary rehabilitation within six months of being discharged.
Pulmonary rehabilitation is an excellent treatment option for many reasons. It is safe and effective in helping patients get back to living their lives and is usually covered by Medicare and private insurance. Used in conjunction with optimized medication, it reduces symptoms and improves activity tolerance and exercise capacity. This comprehensive program uses education, breathing techniques and gentle, supervised exercise that strengthens muscles to ease the burden on lungs. There are numerous pulmonary rehabilitation programs across the country. Here in Connecticut, we are fortunate to have some of the best in the entire nation.
So why is there such an astounding gap in patients receiving the treatment they need? One simple answer: lack of awareness.
The American Thoracic Society (ATS) commissioned a survey that revealed a majority of patients – 62 percent – diagnosed with a chronic pulmonary disorder have never heard of pulmonary rehabilitation. The survey, conducted by Wakefield Research, queried patients diagnosed with COPD, pulmonary hypertension, interstitial lung disease or other chronic pulmonary disorders.
One of the main reasons people don’t know about pulmonary rehabilitation as a viable treatment option is that many don’t want to talk about COPD or other lung diseases. Some patients are smokers; they often don’t speak up about their symptoms and suffer in silence instead. Some feel ashamed of their habit or hopeless that they’ll ever be able to quit, let alone feel better. Many have never been told about pulmonary rehabilitation by their healthcare providers. Lack of healthcare professionals’ knowledge and awareness of pulmonary rehabilitation, and a resultant lack of patient referrals, is another key part of the problem.
Interestingly, people with chronic breathing disorders are often aware of other treatment choices. According to the ATS survey, the majority of patients with a chronic pulmonary disorder have heard of oxygen therapy as well as medicinal interventions, including long-acting or maintenance inhalers, short-acting or rescue inhalers and inhaled or oral steroids as treatments for their disease.
Those of us who are healthy likely don’t realize how difficult everyday life can be for people with a chronic respiratory disease. Half of the ATS survey respondents reported that they avoid carrying items when they walk due to their breathing, while more than half avoid climbing stairs. Respondents also listed needing to avoid household chores like laundry and leaving the house to run errands, such as grocery shopping. However, pulmonary rehabilitation helps patients do activities that have become challenging, if not impossible, for them.
Chronic respiratory diseases may also impact relationships and contribute to feelings of isolation. Respondents revealed that their symptoms have also caused them to avoid attending social events and even playing with their children or grandchildren.
Chronic respiratory diseases cannot be cured, but they are manageable. Most patients can feel better with treatment. In Connecticut, we can set an example and continue to close the knowledge and awareness gap for patients who need pulmonary rehabilitation.
During the holidays, many of us will visit with friends and family we haven’t seen all year. Chances are each of us knows someone struggling with a chronic disease such as COPD. We can do more than just wish our loved ones had a better quality of life. I encourage you to share the real hope of a treatment that works. Learn about pulmonary rehabilitation and find a program today at livebetter.org.
Dr. Carolyn Rochester is a Professor of medicine, pulmonary critical care and sleep medicine at the Yale University School of Medicine.
Sign up for CT Mirror's free daily news summary.
Free to Read. Not Free to Produce.
The Connecticut Mirror is a nonprofit newsroom. 90% of our revenue comes from people like you. If you value our reporting please consider making a donation. You'll enjoy reading CT Mirror even more knowing you helped make it happen.YES, I'LL DONATE TODAY