A new national report from the Ontario Lung Association (OLA) highlights significant knowledge gaps about chronic obstructive pulmonary disease, or COPD that often prevent Canadians with the inflammatory disease from being properly diagnosed and treated.
The title refers to an earlier Canadian Thoracic Society report stating that, while 2 million people in the country are diagnosed with COPD — including chronic bronchitis and emphysema — a million more may have the lung disorder and not know it.
“Helping the Missing Million allows us to better understand the specific factors that prevent people with COPD from receiving proper diagnosis and treatment,” George Habib, OLA’s president and CEO, said in a press release. “This understanding will help us work together with patients and healthcare providers to improve education, collaboration and ultimately, improved outcomes for patients.”
The two surveys were conducted between October and November 2018. One questioned 1,102 Canadians with COPD, while the other surveyed 250 physicians in Canada.
The results showed that more than half of the patients surveyed did not know what COPD was prior to their diagnosis. Among those who had experienced at least one symptom — breathing difficulty, persistent cough, mucus production, and wheezing all are common — 35% did not mention the issue to their physicians. Moreover, about 65% experienced symptoms for at least a year before being diagnosed.
“I had very little knowledge of COPD or how serious it was when I started on my journey, which created challenges when it came to being diagnosed and getting on the right treatment,” said Barbara Moore, a COPD advocate and blogger who was diagnosed in 2015.
“It’s so important for people at-risk of this disease to promptly seek out medical advice, educate themselves about the symptoms, and work closely with their healthcare team to make sure they can be properly diagnosed and treated as quickly as possible,” Moore added.
According to the national report, to ensure timely diagnoses and optimal therapeutic strategies —- both to improve the clinical outcomes of people with COPD and to ease the burden on the healthcare system — better education and improved partnerships between patients and providers are needed.
The publication also calls for stepped-up referrals to lung specialists, as well as enhanced access to spirometry — a test used to diagnose lung diseases such as COPD. It also recommends both improved medication coverage, and awareness and use of patient support programs. In addition, the report suggests a multidisciplinary approach to patient care.
“Uncovering barriers to diagnosing COPD will help us better understand how we can care for patients,” said Andrea Gershon, a respiratory physician and scientist at the Sunnybrook Research Institute. “I believe increased access to spirometry testing and involvement of specialists will improve the diagnosis and subsequently the treatment of COPD, and ultimately help affected people lead their healthiest lives.”
The report highlighted the fact that only 12% of general practitioners, and 21% of specialists consistently adhere to the Canadian Thoracic Society’s treatment guidelines for COPD. That statistic indicates the need for improved understanding of the guidelines, researchers said.
Results from the physician survey and other studies also showed an overuse of corticosteroids, a practice not recommended due to the treatments’ often negative side effects.
Part of an awareness and education campaign, the surveys were conducted in partnership with Boehringer Ingelheim.
“This report puts the focus on meeting patient needs and has the potential to make a significant impact on the more than two million Canadians who live with COPD,” said Andrea Sambati, Boehringer Ingelheim (Canada) president and CEO.
“This report helped to uncover specific challenges when it comes to the diagnosis and treatment of COPD that can be addressed and improve patient outcomes for Canadians,” Sambati concluded.