Programs

COPD Management

The COPD Program is based on the Guidelines from the National Lung Health Education Program and the NGLBI/WHO Global Initiative for COPD (GOLD) guidelines of care. It is further influenced by the Snowdrift Pulmonary Conference 1996 Frontline Treatment of COPD monograph and the 2004 Frontline Update.

Chronic Obstructive Pulmonary Diseases are a major cause of death & disability. In the United States they occur in 10-15% of adults of 55 years of age. COPD does not usually come to medical attention until it has reached an advanced stage, as many patients with mild/moderate COPD have few symptoms and their disease is under diagnosed. Late recognition of COPD results in severe compromise of lung function which may be largely irreversible.

There are several opportunities for intervention through the natural course of the disease. Primary strategies focus n prevention and are best served by public education programs, which reduce the incidence of smoking, both smoking prevention and cessation programs meet these needs. Secondary strategies involve the early detection and prevention of symptomatic disease.

This is the heart of DSM for COPD and will lead to the most successful management of the disease, with maintaining a quality of life for the patient and a cost saving in catastrophic care associated with progression to the tertiary care which is focused on reducing complications in patients with a symptomatic disease state, often with an irreversible outcome.

The COPD Program provides the symptomatic patient the education and support to evaluate their condition daily, and access care in a timely manner. This population will learn to optimize their physical fitness to allow for increased activity at lower levels of O2 consumption and a reduced work of breathing. Pulmonary hygiene techniques are utilized daily, and with a increased frequency based on characteristics of sputum expectoration.

The COPD Program works directly with the primary physician to provide the patient and their family the education and skills to control their disease in the home setting. It assures that the patient care is provided in a step-care format with adjustments made by the patient, both in medications and activity, and the ability to appropriately access the medical system in a proactive manner.

The use of NLHEP Guidelines allows for aggressive evaluation of patients with known or suspected risk factors in a cost effective manner in the primary care setting. This will allow for pre-symptomatic evaluation of airflow obstruction. It is at this point that risk reduction therapies, and medical treatment can be most effective in preserving the patients remaining lung function and preventing disease progression to the symptomatic stage.

It is our belief that COPD is not a disease with irreversible progression. When recognized at the moderate/severe levels in symptomatic patients, that is certainly the case, however early recognition and treatment can reduce progression to asymptomatic levels for many years, allowing for reduced costs of care and improved quality of life.

It is the ability to diagnose and treat in the asymptomatic patient, most often in their primary care setting that is the most effective strategy in long term management of this insidious, debilitating disease.

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