COPD, short for chronic obstructive pulmonary disease, is a progressive respiratory disease2 estimated to affect up to in 10 adults over the age of 40 in the EU.3 Mortality from respiratory diseases is the third main 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 carries a hefty economic burden,5 including loss of productivity6 and mounting healthcare costs,6 as well as placing an immense burden on healthcare systems2,7 a single COPD exacerbation can increase the risk of future by 21.8 Experts estimate global COPD costs will rise to $4.8 trillion in 2030.5
Despite the significant impact of COPD on patients and healthcare systems and medical progress in diagnostics and disease management, COPD is often unknown, resulting in it being undertreated,9 under-prioritied10 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 are getting the right diagnosis and care to manage their chronic respiratory disease ha, for the most part, been absent. For many people, this means a COPD diagnosis often leads to poor quality of life, declining health and fear.”
John Hurst, rofessor of espiratory edicine at University College London, says “COPD does not receive attention proportionate to its burden on individuals and society. With the COPD mortality rate rising, 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 diseases into the spotlight and has resulted in some increased recognition of respiratory diseases as a key public health issue, much more needs to be done especially in support of patients with COPD. For example, as part of Healthier Together initiative, the EU has identified chronic respiratory diseases as a priority, but falls short of a clear prioritiation of COPD.12
Both experts stress that healthcare systems and policymakers must act urgently to prioritie COPD. “To catalye this change, the first step we needed to take was defining exactly what optimal standards of care should look like for COPD,” says Winders.
With the COPD mortality rate rising, we desperately need to create a basic level of care that a person living with COPD should expect.
New quality standards for COPD care
Today, for the first time, a new set of global quality standards for COPD exist that outline the global health system priorities to ensure consistent standards of care for those living with COPD.
“We know COPD treatment regimens aligned with global recommendations reduce the risk of flare-ups and keep COPD-related costs down,” says Hurst. Perhaps unsurprisingly, given the inertia surrounding COPD management, these standards are often not in place in many countries, and this, Hurst argues, creates a gap in the quality of care available.
Winders says this is something patients are all too familiar with. “I’ve heard so many patients talk about not being able to access the care they desperately need, whether that stems from a lack of recognition of COPD by clinicians, the cost of care or indeed some other barrier… there are several reasons why a person with COPD cannot access good care.” She adds “That’s why these new quality standards are critical to the COPD community, here in the EU and worldwide, as they bridge this gap between clinical guidelines and the real-world care patients experience.”
Organied and funded by AstraZeneca, along with a multidisciplinary group of COPD experts and patient advocates, the five new evidence-based quality standards can translate into a real-world blueprint of essential steps designed to help healthcare professionals achieve optimal health outcomes for their patients, across the entire continuum of care.
New quality standards are critical to the COPD community … as they bridge this gap between clinical guidelines and the real-world care patients experience
Hurst describes how these new quality standards add to existing guidelines: “What’s great about these quality standards is that they complement current clinical COPD guidelines, and strengthen their implementation, while also 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 improve the trajectory of COPD care and begin to prioritie it proportionately to its burden. “I know for many patients, adopting these quality standards in their country can drive meaningful and welcome change, bringing them one step closer to accessing the care they deserve,” says Winders.
To date, only five countries globally and two in the EU have quality standards in place.13 The new quality standards have been designed to apply to all healthcare settings, including those with more fragmented health systems within Europe and beyond.
A unified voice that stands together with existing initiatives
Ultimately, both experts hope that the new quality standards will accelerate the journey to deliver optimal care for people living with COPD. However, the quality standards can only fulfil this potential if their implementation and usage within COPD care are done in close collaboration with all key players, starting with national patient advocacy groups, healthcare professionals, and policymakers.
The publication of these quality standards helps strengthen and support existing efforts and initiatives to improve respiratory care, currently being led by a few courageous stakeholders and policymakers.
For instance, Gitta Vanpeborgh, a member of Belgium’s Federal Parliament, who’s spearheading a resolution with a series of proposals to the Belgian government to improve COPD care pathways, including prioritiing multidisciplinary speciality care and improving access to prevention and screening initiatives. Vanpeborgh’s work not only serves as a critical milestone to improve COPD care in Belgium and Europe but it also adds to the growing number of calls to improve COPD care globally, such as these quality standards.
Multi–faceted campaigns that take a partnership approach, like Speak Up for COPD, are also vital to help raise awareness and understanding of this disease and further strengthen the urgency of these calls.
Winders believes cohesive, cross-stakeholder action that coalesces multiple initiatives is essential for realiing their common goal. “Only when we bring these campaigns together can we achieve a standard of care that empowers people living with COPD to make healthier choices and live the highest quality of life possible.”
There is still some way to go in the fight to combat COPD, but Winders adds that “one thing remains abundantly clear: we must not relent on our mission to deliver quality care for all”
Organised and funded by AstraZeneca with input from John Hurst, Professor of Respiratory Medicine at University College London and Tonya Winders, CEO and President of the Global Allergy and Airways Patient Platform.
—
A detailed version of the quality standards is published in Advances in Therapy.
References:
- World Health Organization. The 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 Lung Disease (GOLD) 2022. [Online]. Available at: https://goldcopd.org/2022-gold-reports-2/. [Last accessed: May 2022].
- European lung white book. 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 disease. 2018;13:2301.
- May SM, et al. Burden of chronic obstructive pulmonary disease: healthcare 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.
- Make B, Dutro MP, Paulose-Ram R, Marton JP, Mapel DW. Undertreatment of COPD: a retrospective analysis of US managed care and Medicare patients. International Journal of Chronic Obstructive Pulmonary Disease. 2012; 7: 1.
- Yorgancioglu A, Khaltaev N, Bousquet J, Varghese C. The Global Alliance Against Chronic Respiratory Diseases: journey so far and way ahead. Chinese Medical Journal. 2020; 133: 1513–1515. doi: 10.1097/CM9.0000000000000851.
- Ballreich JM, Gross CP, Powe NR, Anderson GF. Allocation of National Institutes of Health Funding by Disease Category in 2008 and 2019. JAMA Network Open. 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 Diagnosis and Management of COPD: A Global Perspective. Advances in Therapy. 2022:1-21.