COPD, short for Chronic Obstructive Pulmonary Disease, is a progressive respiratory disease2 it is estimated to affect up to 10 adults over the age of 40 in the EU.3 Mortality from respiratory diseases is the third leading cause of death in EU countries, and 40 of these deaths result from COPD.4
Beyond the physical and emotional cost, this chronic respiratory disease also brings a heavy economic burden,5 of which loss of productivity6 and rising health care costs,6 while placing an immense burden on health systems2.7 a single exacerbation of COPD can increase future risk by 21.8 Experts estimate that the global costs of COPD will reach $4.8 trillion by 2030.5
Despite the significant impact of COPD on patients and healthcare systems and medical advances in disease diagnosis and management, COPD often goes unrecognized, making it undertreated,9 sub-priorityten and underfunded.11
Tonya Winders, CEO and resident of the Global Allergy and Airways Patient Platform, describes the impact of this on people with COPD “National standards that ensure patients receive the right diagnosis and care to manage their chronic respiratory disease ha, for the most part, been absent. For many people, this means that a diagnosis of COPD often leads to poor quality of life, declining health and fear.
John Hurst, professor of respiratory medicine at University College London, says “COPD is not receiving attention commensurate with its burden on individuals and society. With the COPD death rate increasing, we desperately need to create a basic level of care that a person living with COPD should expect.
While the COVID-19 pandemic has thrust respiratory illnesses into the spotlight and led to some increased recognition of respiratory illnesses as a key public health issue, much more needs to be done, particularly to support patients with COPD. For example, under the Healthier Together initiative, the EU identified chronic respiratory diseases as a priority, but did not set a clear priority for COPD.12
Both experts stress that health systems and policy makers must act urgently to prioritize COPD. “To catalyze this change, the first step we needed to take was to define exactly what the optimal standards of care for COPD should look like,” says Winders.
NOTuh qQuality Standards for COPD Care
Now, for the first time, a new set of global quality standards for COPD exist which outlines global health system priorities to ensure consistent standards of care for people with COPD.
“We know that COPD treatment regimens aligned with global recommendations reduce the risk of flare-ups and reduce COPD-related costs,” says Hurst. Perhaps unsurprisingly, given the inertia surrounding COPD management, these standards are often not in place in many countries, which Hurst says creates a gap in the quality of care available.
Winders says it’s something patients know all too well. “I’ve heard so many patients talk about not being able to access the care they desperately need, whether it’s because of a lack of recognition of COPD by clinicians, the cost of care, or even some other obstacle…there are many reasons why a person with COPD cannot access good care. She adds, “That’s why these new quality standards are essential for the COPD community, here in the EU and around the world, as they bridge that gap between clinical guidelines and the real patient experience.
Organized and funded by AstraZeneca, with a multidisciplinary group of COPD experts and patient advocates, the five new evidence-based quality standards can translate into a concrete plan of essential steps designed to help professionals professionals to achieve optimal health outcomes for their patients, across the continuum of care.
Hurst describes how these new quality standards add to existing guidelines: “The great thing about these quality standards is that they complement current COPD clinical guidelines and reinforce their implementation, while providing clear guidance to inform systemic policy change. »
Both believe that by simply choosing to adopt the quality standards, countries can take an immediate first step to improving the trajectory of COPD care and begin prioritizing it commensurate with its burden. “I know that for many patients, adopting these quality standards in their country can lead to significant and welcome changes, bringing them one step closer to accessing the care they deserve,” says Winders.
To date, only five countries in the world and two in the EU have quality standards in place.13 The new quality standards have been designed to apply to all healthcare institutions, including those with more fragmented healthcare systems in Europe and beyond.
A unified voice that stands alongside existing initiatives
Ultimately, the two experts hope the new quality standards will speed up the journey to provide optimal care for people with COPD. However, quality standards can only realize this potential if their implementation and use in COPD care is done in close collaboration with all key players, starting with national patient advocacy groups, health professionals and policy makers.
The publication of these quality standards helps to strengthen and support existing efforts and initiatives to improve respiratory care, currently led by a few courageous actors and decision makers.
For example, Gitta Vanpeborgh, Member of the Belgian Federal Parliament, who is at the forefront of a resolution with a series of proposals to the Belgian government to improve COPD care pathways, including prioritizing specialist care multidisciplinary and improving access to prevention and screening initiatives. Vanpeborgh’s work not only serves as a critical step to improve COPD care in Belgium and Europe, but it also adds to the growing number of calls to improve COPD care around the world, such as these quality standards.
–Faceted campaigns that take a partnership approach, like Speak Up for COPD, are also essential to help raise awareness and understanding of this disease and further reinforce the urgency of these calls.
Winders believes that cohesive, multi-stakeholder action that brings together multiple initiatives is essential to achieving their common goal. “It’s only when we bring these campaigns together that we can achieve a standard of care that empowers people with COPD to make healthier choices and live the highest quality of life possible.”
There is still a long way to go in the fight against COPD, but Winders adds that “one thing remains very clear: we must not relax our mission to provide quality care for all”.
Organized and funded by AstraZeneca with contributions from John Hurst, Professor of Respiratory Medicine at University College London and Tonya Winders, CEO and Chair of the Global Allergy and Airways Patient Platform.
A detailed version of the quality standards is published in Advances in Therapy.
- World Health Organization. Top 10 causes of death. [Online]. Available at: https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death. [Last accessed: April 2022]
- GOLD. Global Strategy for the Diagnosis, Management and Prevention of COPD, Global Initiative for Chronic Obstructive Pulmonary Disease (GOLD) 2022. [Online]. Available at: https://goldcopd.org/2022-gold-reports-2/. [Last accessed: May 2022].
- European lung white paper. 2013. Chapter 13 Chronic Obstructive Pulmonary Disease. Available at: https://www.erswhitebook.org/chapters/chronic-obstructive-pulmonary-disease/ [Last accessed: May 2022].
- OECD/European Union. 2018. “Mortality from respiratory diseases”, in Health at a Glance: Europe 2018: State of Health in the EU Cycle, OECD Publishing, Paris/European Union, Brussels.
- Bloom DE, et al. The global economic burden of noncommunicable diseases. Geneva: World Economic Forum; 2011. Available at: https://world-heart-federation.org/wp-content/uploads/2017/05/WEF_Harvard_HE_GlobalEconomicBurdenNonCommunicableDiseases_2011.pdf. [Last accessed: May 2022].
- Patel JG, et al. COPD affects worker productivity and health care costs. International Journal of Chronic Obstructive Pulmonary Diseases. 2018;13:2301.
- But, et al. Burden of chronic obstructive pulmonary disease: health care costs and beyond. Allergy Asthma Proc. 2015 ; 36:4-10.
- Rothnie KJ, et al. Natural history of chronic obstructive pulmonary disease exacerbations in a general practice-based population with chronic obstructive pulmonary disease. Am Jour of Resp Crit Care Med. 2018; 198 (4): 464-471.
- Brand B, Dutro MP, Paulose-Ram R, Marton JP, Mapel DW. COPD undertreatment: a retrospective analysis of US managed care and Medicare patients. International Journal of Chronic Obstructive Pulmonary Diseases. 2012; 7:1.
- Yorgancioglu A, Khaltaev N, Bousquet J, Varghese C. The Global Alliance against Chronic Respiratory Diseases: how far we have come and how far we have to go. Chinese medical journal. 2020; 133: 1513-1515. doi: 10.1097/CM9.0000000000000851.
- Ballreich JM, Gross CP, Powe NR, Anderson GF. Breakdown of National Institutes of Health funding by disease category in 2008 and 2019. Open JAMA Network. 2021; 4(1): e2034890-.
- European Commission. Healthier together – EU Non-communicable diseases. [Online]. Available at: https://ec.europa.eu/health/non-communicable-diseases/overview_en. [Last accessed: May 2022].
- Bhutani M, Price DB, Winders TA, Worth H, Gruffydd-Jones K, et al. Quality standard position statements for health system policy changes in the diagnosis and management of COPD: a global perspective. advances in therapy. 2022:1-21.