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Chronic obstructive pulmonary disease (COPD) ? an umbrella term for progressive
respiratory conditions including emphysema and chronic bronchitis ? is a
rapidly escalating chronic health problem both in the United States and
worldwide. An estimated 13 million Americans have been diagnosed with the
disease and nearly twice that number show some degree of impaired lung
function. The price tag for COPD is high ? direct medical costs reached nearly
$30 billion in 2010.1 The human toll is equally steep in terms of
disability, poor quality of life, and premature death. Despite the magnitude of
the problem, COPD is widely underdiagnosed and under-treated.2
Spirometry testing is a key tool for identifying COPD. This simple, noninvasive
airflow measurement can be performed in a primary care physician?s office by
properly trained personnel.3 The test compares the volume of air a
person can breathe out in one second (forced expiratory volume or FEV1) to the
maximum amount that can be expelled in a forced exhalation (forced vital
capacity or FVC). A FEV1/FVC ratio that is below 70 percent
indicates impaired breathing function and the possibility of COPD. A key
characteristic that differentiates COPD from other lung conditions (such as
asthma) is that breathing does not improve with bronchodilation. After baseline
testing, if the bronchodilator is administered and there is no difference
between the two readings, the diagnosis of COPD is supported rather than
asthma.2
Between 80 and 95 percent of deaths from COPD are related to cigarette
smoking.1 Other high-risk groups include those exposed to
second-hand smoke and environmental or occupational pollutants and people with
a family history of respiratory disease. Individuals fitting these criteria who
exhibit symptoms of cough, sputum production, or dyspnea should be evaluated
for COPD. The National Committee for Quality Assurance (NCQA) COPD Initiative
recommends spirometry testing for:
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patients ages 40 or older who have newly diagnosed COPD;
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patients who have newly active disease (previously diagnosed COPD patients that
have not seen a doctor about the disease or had spirometry testing within the
two years prior to the current visit).
In both cases, the test should be performed within 180 days of the initial
diagnosis or newly active disease.4
COPD is progressive and irreversible. Smoking cessation is the only
intervention that has been proven to slow the decline in lung function. By
identifying COPD at an early stage, primary care physicians are in a better
position to help their patients make this lifestyle change before lung damage
becomes severe. Treatment for most patients consists of a step-wise approach to
managing symptoms with medications and oxygen therapy based on the stage of the
disease.2
We can help
The ConnectionsSM Program offers your patients access to Health
Coaches ? health care professionals such as registered nurses and registered
respiratory therapists ? who can offer guidance and support to COPD patients.
To learn more about the health coaching services available to your practice,
call 1-866-866-4694. You can also refer your
patients to a Health Coach by completing the fax referral form that is
available online at www.ibx.com/providerconnections
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