What is COPD?
(This information was provided by The Lung Association)
Chronic Obstructive Pulmonary Disease (COPD) is a respiratory disorder that causes the airways of the lungs to be inflamed and become "obstructed" or blocked.
- Chronic – means it won’t go away
- Obstructive – means partly blocked
- Pulmonary – means in the lungs
- Disease – means sickness
The two major forms of the disease include chronic bronchitis and emphysema, though these frequently coexist.
Chronic bronchitis is an inflammation of the airways in the lungs that leaves them irritated. The irritation affects the glands in the airways, producing extra mucus that then blocks the airways resulting in a person coughing, spitting or finding it difficult to draw a breath.
Emphysema damages and destroys lung tissue and large air pockets develop in the lungs where the air becomes trapped, causing a person to struggle to draw a breath.
Prevalence in Canada
COPD is the fourth most common cause of hospitalization among men and the sixth most common cause of hospitalization among women. Approximately 500,000 people over the age of 35 have been diagnosed with COPD, and it is estimated that an almost equal number of middle-aged Canadians may also have COPD, but are not aware of it. In fact, by 2020, it is estimated that COPD will be the third leading cause of death worldwide.
Beyond the obvious impact COPD has on patients and their families, the impact on the Canadian healthcare system is also significant. The annual direct cost of COPD (i.e., diagnosis, hospitalization, emergency room visits) is almost $2,000.00 per patient. Add to this, the indirect cost associated with work loss and absenteeism amounting to approximately $1,000.00 per patient. Total costs for COPD in Canada cost $1.67 billion in 1998.
Most people with COPD are not diagnosed until the disease is well advanced. Physicians may use the following criteria to determine if a breathing test, or spirometry, is needed to confirm if a patient has COPD:
• Smoker or ex-smoker, 35 years of age and older
• Constant cough and sputum production
• Activity-related shortness of breath
• Frequent colds or respiratory tract infections
If COPD is detected early, there are steps that can be taken to prevent further lung damage and to help the patient feel better. To help Canadians recognize the symptoms of COPD and encourage early diagnosis, The Lung Association and the Canadian Thoracic Society (CTS) are introducing a new self-assessment tool, The Canadian Lung Health Test, available online at www.lung.ca/breathworks.
COPD is a preventable and treatable disease. To optimize early diagnosis, prevention and management of COPD in Canada, the CTS introduced new treatment guidelines in June 2003.
According to the guidelines, the goals of managing COPD are to prevent disease progression, reduce and alleviate breathlessness and other respiratory symptoms, improve exercise tolerance, prevent and treat flare-ups, and reduce mortality. The guidelines recommend a stepwise approach to management, based on severity of symptoms and disability. Key recommendations include: smoking cessation and education that incorporates a self-management plan should be offered to all patients; bronchodilator therapy should be prescribed to achieve maximum symptom control and some patients may benefit from the addition of inhaled corticosteroids (ICSs); it is also imperative that patients be encouraged to engage in regular exercise so as to avoid deconditioning. In addition, enrolment in a supervised pulmonary rehabilitation program is preferred and strongly advocated for all patients. Supplemental oxygen and surgery are reserved for consideration in patients with advanced stages of the disease.
The full executive summary of the Canadian Thoracic Society recommendations for management of chronic obstructive pulmonary disease – 2003 can be found at www.pulsus.com under the Canadian Respiratory Journal, May/June 2003 Issue.
- Bronchodilators – for relief and maintenance
- Inhaled steroids – for prevention of flare-ups in selected patients with more advanced COPD
- Antibiotics – for fighting infection
- Vaccines – for flu and pneumonia; also for prevention
- Supplemental oxygen – to prolong life in patients with critically low oxygen in their blood
Although there is no cure for COPD, the earlier it is diagnosed, the sooner a person can begin to manage his/her health and improve their quality of life.
The Lung Association
The Lung Association is a registered charity that provides information and funding for research to improve lung health. We focus on the prevention and control of asthma, chronic lung disease, tobacco cessation and prevention, as well as air quality and its effects on lung health. For further information, call The Lung Association at 1-888-566-5864 (LUNG).
The Canadian Thoracic Society (CTS) is the Association’s medical section, and advises the Association on scientific matters and programs including policies regarding support for research and professional education.
For more information about COPD diagnosis, treatment, and management, contact:
The Lung Association’s BreathWorks Program, an initiative designed to help patients, and their families and caregivers, cope with the emotional hurdles and physical challenges of living with COPD.
Call the toll-free BreathWorks Helpline at 1-866-717-COPD (2673).
- Centre for Chronic Disease Prevention and Control. Editorial Board for Respiratory Disease in Canada, Health Canada, Ottawa, Canada, 2001.2.
- Ernst PP, Bourbeau J, Rainville B, Benayoun S, Suissa S. Underestimation of COPD as a cause of death. Eur Respir J 2000; 16 (Suppl. 31) :13s.
- Murray CJ, Lopez AD. Alternative projections of mortality and disability by cause 1990-2020; Global Burden of Disease Study. Lancet 1997; 349; 1498-504.
- K.R. Chapman et al. The Burden of COPD in Canada: Results from the Confronting COPD survey. Respiratory Medicine; March 2003: vol.97 (supplement C), S23-S31.
- Economic Burden of Illness in Canada 1998. Health Canada, Ottawa, Canada, 2002.