Tailoring COPD Treatment To Everyday Impact Of Disease Can Help Patients Lead The Lives They Want

Main Category: COPD
Article Date: 10 Jun 2008 - 3:00 PDT

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Leading UK experts in chronic obstructive pulmonary disease (COPD) are calling for healthcare professionals (HCPs) to place greater emphasis on the impact of the disease on patients' everyday lives when tailoring care1. This is amongst the key recommendations drawn from the results of the 'Unleash the life within …' a patient's perspective of living with Chronic Obstructive Pulmonary Disease (COPD) Survey, which focussed on the potential positive impact that a COPD patient could experience, through effective management of their physical, emotional and practical needs.

The survey of 326 people with COPD conducted in April 2008 reveals that although the disease has adverse effects on many aspects of daily life1, and this impact is of most concern to patients, symptom control appears to be of greater importance to HCPs1.

"The results of this survey are striking. They confirm many people with COPD cannot lead the lives they want. Their symptoms are getting worse, and a significant proportion need hospital admission. Their COPD has a major negative impact on simple everyday activities that other people of the same age take for granted," said Professor Martyn Partridge, collaborator on the 'Unleash the life within…' report and Professor of Respiratory Medicine at Imperial College London.

"In addition, the results show us that there is a disparity between what the patients want and the care they currently receive. Although it is encouraging that the majority of patients surveyed told us that they had their COPD reviewed by a doctor or nurse during the previous 12 months, many HCPs are not focusing on what's really important to the patients - the effect COPD can have on daily life. Encouraging patients to attend support groups, as well as highlighting the benefits of services such as pulmonary rehabilitation, would identify a way for the HCP to do more for the patient that wants more from their life" he continues.

Key findings

The results show that COPD can prevent people from living the lives they want and, despite medication, is not always well controlled:

- 46% of people who took part in the survey said that being unable to walk a short distance had the most negative impact on their everyday lives1

- Feeling chronically tired (26%), depressed and frustrated (28%) also made patients' lives less enjoyable1

- 24% of participants felt that being unable to take part in hobbies or play with their grandchildren had the worst effect on their everyday lives1

- Responses showed that people with COPD who took part in the survey used a wide range of medicines to relieve their symptoms and control their disease, however, 24% thought their symptoms were getting worse, and 21% felt that their COPD was not well controlled1

The results suggest that although the majority of patients are regularly reviewed, HCPs may not be placing enough emphasis on the impact of poorly controlled symptoms on patients' lives:

- 85% had their COPD reviewed by a doctor or nurse during the previous 12 months1

- Most healthcare professionals asked about clinical symptoms, but only 32% of people were asked about the effect of their COPD on their everyday lives1

- Less than fifty per cent (46%) stated they had been offered supportive therapies, such as a home visit by a nurse, or physiotherapy or rehabilitation courses1. These services were mostly offered to people who had been admitted to hospital twice or more, for their COPD in the previous 12 months

Furthermore, around 40% of people felt that if their treatment could make them feel less exhausted (40%) and enable them to walk short distances (38%), this would have the greatest positive effect on their everyday lives1.

The future of COPD care

The 'Unleash the life within….' survey was conducted to help inform discussion about how COPD affects everyday lives, and how well current services are meeting people's physical, emotional and practical needs1.

Dr Iain Small, collaborator on the 'Unleash the life within…' report and General Committee Chair, General Practice Airways Group (GPIAG), and Principal General Practitioner, Peterhead Health Centre, comments, "The results of this survey come at a crucial time. At long last COPD is moving up the health agenda and within the next 12 months, the Department of Health will complete a National Service Framework (NSF) for COPD."

"By drawing attention to the shortfalls of current care - as well as its strengths - we hope that this report will focus attention on the goals of treatment which matter most to people with COPD, so that the most effective strategies can be devised for achieving them," he continues.

The 'Unleash the life within…' survey and report were sponsored by AstraZeneca UK and jointly developed in association with Taylor Nelson Sofres (TNS) Healthcare.

Notes

COPD is the 5th biggest killer in the UK2; an estimated 3.7 million people in the UK have it2; around 30,000 people in the UK die from COPD each year which is more than from bowel cancer, breast cancer or prostate cancer2

The collaborators on the report are:

- Martyn R Partridge MD FRCP, Professor of Respiratory Medicine, Faculty of Medicine, Imperial College London, NHLI Division at Charing Cross Hospital

- Iain R Small MBChB FRCGP, General Committee Chair, General Practice Airways Group (GPIAG), and Principal General Practitioner, Peterhead Health Centre

- David Long RGN MSc, Publications Editor, Association of Respiratory Nurse Specialists (ARNS) and Senior Respiratory Nurse Specialist, Somerset Lung Centre, Taunton and Somerset Hospital Foundation Trust

- Anna Murphy MSc MRPharmS, Chair, UKCPA-Respiratory Group, Member of External Reference Group, COPD National Service Framework and Consultant Respiratory Pharmacist, University of Leicester Hospitals NHS Trust

- Editorial support was provided by AstraZeneca UK

COPD patients were recruited by Taylor Nelson Sofres (TNS) Spotlight Methodology1

- Questionnaires dispatched to community pharmacists on our spotlight panel
- Pharmacist handed out questionnaire to all patients collecting COPD medication
- Respondents completed the questionnaire and handed it back to the pharmacist for return to TNS Healthcare
- Fieldwork and analysis conducted in April 2008
- 326 questionnaires were processed from patients aged 46 years and over

About AstraZeneca

AstraZeneca is a major international healthcare business engaged in the research, development, manufacture and marketing of prescription pharmaceuticals and the supply of healthcare services. It is one of the world's leading pharmaceutical companies with healthcare sales of $26.47 billion and leading positions in sales of gastrointestinal, cardiovascular, neuroscience, respiratory, oncology and infection products. AstraZeneca is listed in the Dow Jones Sustainability Index (Global) as well as the FTSE4 Good Index. http://www.astrazeneca.com

References

1. Data on file - SYMB56 May 2008
2. British Lung Foundation. Invisible Lives. Chronic Obstructive Pulmonary Disease (COPD) - finding the missing millions, November 2007

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