# Presentation: 746842

## Presenting Organization

- Event Name
- Event Date
- Presenter Name, Title

**COPD Essentials for Physicians**

- www.LearnAboutCOPD.org

**Notes:**
Good (morning, afternoon, evening).  My name is X.  I am (title, organization, background).

I am pleased to be here today to speak to you about a very serious disease – Chronic Obstructive Pulmonary Disease—what we hope everyone here currently is, or from now on will be, referring to as COPD. 

As you know, COPD is a general term that includes a spectrum of diseases.  Your patients may frequently have elements of emphysema along with obstructive bronchitis.  In fact, it is more common for patients to have elements of both, which is why we prefer the term COPD.

## Why COPD?  Why Now?

- 4th leading cause of death
- Only top killer with increasing mortality
- 12 million diagnosed
- Another 12 million undiagnosed

**Notes:**
So why are we devoting an entire presentation to COPD—a disease that so many of our patients have never even heard of? 

COPD is the fourth leading cause of death in the United States.

It kills more than 120,000 Americans each year.

In fact, of the leading killers, COPD is the only disease with mortality rates that are on the rise rather than on the decline. 

More than 12 million people have COPD and an additional 12 million do not even know that they have it. 
The rates among women have dramatically increased since World War II. In 2002, more women than men died of COPD.

## Why COPD?  Why Now? 

- COPD patients **will** become a greater proportion of caseload.
- Treatment advances
- Can improve quality of life.
- May slow the progression of the disease.
- Diagnosis is key.

**Notes:**
Perhaps the most important reason that COPD needs to be on our radar now is because it’s not going to go away. 

As mortality rates rise, the provider community must be expect and prepare for a wave of COPD patients in the coming years.

COPD patients will become a greater proportion of caseload, particularly in the primary care setting. 

The good news is that there is hope for improvement on the COPD front and there is a great deal that we in the provider community can do to help.  

Recent advances in treatment are making a difference. 

## Risk Factors

- Age 40 and over
- Persistent/progressive dyspnea
- Chronic cough
- Sputum production
- Unusual and noticeable decline in activity level, especially with smoking history.
- Genetic factors (AAT deficiency) and occupational exposures also play a role.
***1 out of 6 Americans with COPD has never smoked***

**Notes:**
So who is at risk for COPD?

Providers should consider a COPD diagnosis in men and women over age 40 with symptoms such as shortness of breath, cough, sputum production, or an unusual decline in activity level, especially with a history of smoking.  

Symptoms of COPD may be very subtle at first, causing subtle limitations. Your patients may be making small accommodations in their everyday lives—and attribute changes to gaining weight, getting older or being out of shape.  They may do small things like avoiding stairs, giving up a sport, or limiting shopping or other activities of daily life.  These changes do not typically drive them to seek medical consultation. 

For example, the patient may complain of a need to simply “slow down” or express that they’re “just not able to do what they used to do” and might even attribute this to “getting older.”  If the patient does not present with these complaints, the provider should engage the patient and inquire as to how the patient is functioning on a day to day basis—“Are you feeling the need to slow down or that you’re not able to do some of the things you used to?  Do every day chores seem to require more effort?  Tell me more....”

Genetic and environmental factors can also play a role.

One critical note to keep in mind—While many of us are quick to look for COPD in our patients who smoke, it is important for us to remember that as many as 1 out of 6 people with COPD has never smoked. 

## Diagnosis:  Pulmonary Function Testing

- Spirometry
- Determines severity
- Distinguishes from asthma
- Diagnosis
- FEV1/FVC<0.7 (postbronchodilator)
- Smoking cessation

**Notes:**
If you are considering a diagnosis of COPD, the next step is to perform or refer the patient for a lung function test—spirometry – to confirm the diagnosis, determine the severity of the disease, and distinguish COPD from asthma.  

A criterion for diagnosis of COPD is a postbronchodilator FEV1/FVC<0.7.  

These patients should receive professional assistance for smoking cessation. 

## Treatment

**Notes:**
As demonstrated in this graphic, COPD is a progressive disease.  The good news is that it progresses slowly—thus the emphasis on early diagnosis.  Once symptoms are identified and a diagnosis is made, providers must monitor and follow up with the patient on a regular basis to be sure that treatment is appropriate for the level of disease severity. 

## Treatment

- Early detection and early treatment can slow COPD and improve quality of life.
- Aggressive management makes a difference.
- Advances in therapies can improve survival or quality of life.
- Smoking cessation
- www.smokefree.gov

**Notes:**
While we know that there is no cure for COPD, it is critical to the well-being of our patients that we convey a sense of hope.  Thanks to recent advances in treatment, we can work with our patients to improve survival and quality of life. 

For those COPD patients who smoke, only smoking cessation can truly alter the course of the disease.  Research shows that approximately 70 percent of smokers have at least one primary care visit per year and about the same number have expressed a desire to quit smoking.  

There have been many improvements in cessation techniques in recent years.  For information on some of these new resources and tools for your patients, visit www.smokefree.gov.  There is a specific link on the site with resources for health professionals.

## Summary 

- Diagnosis and treatment of COPD is worth our efforts and attention.
- Consider COPD diagnosis in  your patients with chronic shortness of breath.
- Proactive treatment can improve and extend lives.

**Notes:**
In closing, let me recap three main points we hope you will take away from this presentation—
Diagnosis and treatment of COPD is worth our efforts and attention. 
Consider COPD diagnosis in your patients with chronic shortness of breath.
Proactive treatment can improve and extend lives. 

## Learn More  Breathe Better

- _[www.LearnAboutCOPD.org](http://www.learnaboutcopd.org/)_
- or
- NHLBI Health Information Center
- P.O. Box 30105
- Bethesda, MD 20824-0105
- Phone:  301-592-8573
- TTY:  240-629-3255
- Fax:  301-592-8563
- E-mail:  _[NHLBIinfo@nhlbi.nih.gov](mailto:NHLBIinfo@nhlbi.nih.gov)_
- Web site: _[www.nhlbi.nih.gov](http://www.nhlbi.nih.gov/)_

**Notes:**
For more information about COPD or to order educational materials—like fact sheets for your patients or provider reference cards that sum up some of the key points we discussed today, please visit the National Heart, Lung, and Blood Institute’s COPD Awareness and Education Campaign Web site or contact the NHLBI Health Information Center directly. 

Thank you very much for your time and attention.  If anyone has any questions, I’ll be happy to take them at this time.