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COPD needs to learn risk reductions lessons from heart disease

Takeda-backed report says HCPs working in COPD need to learn from progress made by their colleagues in cardiovascular medicine

Dr Alan Kaplan discusses the report

Healthcare professionals working in chronic obstructive pulmonary disease (COPD) need to learn from the progress made in the cardiovascular disease community, according to a new Takeda-backed report.

Launched at the European Respiratory Society Annual Congress in Vienna, Austria, The Shifting Paradigm in COPD Management report says that more attention needs to be paid to the prevention of disease progress, rather than just treating the symptoms, taking the changes made here in cardiovascular disease (CVD) care as a reference point.

Takeda's key COPD product is its selective phosphodiesterase 4 (PDE4) enzyme inhibitor Daxas (roflumilast). The once-daily pill was acquired through its takeover of Nycomed last year and was launched in Europe in 2010.

The report's publication follows updates made by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) to its treatment recommendations to combine an assessment of a patient's current symptoms with any future risks of disease progression.

The matter is particularly pressing, with COPD set to climb from the fourth most common disease in the world to the third by 2030, due to an increase in ageing population and the factors behind contracting COPD, including smoking and pollution.

Despite this projected increase, awareness of COPD remains low, with Dr Alan Kaplan, chair of the Respiratory Medicine Special Interest Focus Group of the College of Family Physicians of Canada, and one of the report's contributors, citing a report that claimed 50 per cent of exacerbations – when a patient's condition declines significantly for a period of time – were not reported.

The reasons for this are varied and can include a lack of knowledge regarding the symptoms of an exacerbation, as well as patient resistance to having a doctor influence their lifestyle choices, such as smoking.

However, this could be changed if the COPD community looks to progress in CVD care during the past few decades, according to Dr Kaplan.

Speaking to PMLiVE, he said: “If we educate people aggressively about what they should be afraid of, they learn. So you know that if you have chest pain, and pain going down your left arm and shortness of breath, you go to a hospital to make sure you're not having a heart attack because you could die.

“If you get submitted to a hospital because of a COPD exacerbation, you're risk of in-hospital mortality is that same as that of an acute heart attack. Now that's pretty scary, and not recognised.”

See a video interview with Dr Kaplan at the top of this article.

Another of the report's authors, Professor Wisia Wedzicha, backed Dr Kaplan's views on improving education as part of this “paradigm shift” in care, referencing a study that found only 2 per cent of patients with COPD knew what an exacerbation was.

“We've got to encourage our patients to seek treatments that will prevent [exacerbations], even if they don't yet have immediate symptomatic benefit.”

And key to this is improving patient/physician communications, said Prof Wedzicha: “If patients participant and understand and trust their doctor, this will improve adherence to preventive treatments, like there is with CVD. There's no problem giving a statin to someone with CVD, and we've got to look at treatment in the same way.”

Other contributors to the report, which was published and developed by Takeda, included Dr Ondrej Rybnicek from the European Federation of Allergy and Airways Diseases Patients' Assoication (EFA) and Dr Robert Horne, a professor of behavioural medicine at University College London.

3rd September 2012

From: Healthcare

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