How Can Doctors Better Care for COPD Patients?

More could be done to effectively care for chronic obstructive pulmonary disease (COPD) patients, according to findings commissioned by The Lancet Respiratory Medicine and presented at the American Thoracic Society International Conference.

Researchers from the University of Michigan explored seven major areas of focus within COPD care in order to determine if patients currently receive adequate treatment.

"We found there are huge problems in access to and standards for care for some of society's most vulnerable patients,” lead author Meilan Han, MD explained in a press release.

The 27 respiratory medicine experts outlined their key findings in each category:

1. As COPD more often affects individuals from low socioeconomic backgrounds with less access to education, medication and non-medication interventions need to improve for this population. Plus, the researchers discovered a lack of sufficient training around the disease among medical providers, especially healthcare professionals in primary care settings.

2. Patients’ biggest expenses are often the out-of-pocket costs for drugs, which result in increased overall healthcare costs and reduced adherence. Patients sometimes decide to skip out on medications or certain doses to save money.

3. Thus, drug makers and pharmaceutical companies need to consider cost effective-options for both healthcare payers and patients, the researchers said, commenting that more research and new drugs to slow or stop disease progression are needed. This is especially important for chronic diseases like COPD, they added, compared to other diseases with high mortality rates.

4. Because the research for self-management programs in COPD is minimal, insurance coverage for these programs is too, the authors wrote. More studies in this area are needed, including areas such as telemedicine and palliative care, both of which can reduce clinic visits for patients, the investigators said.

5. Readmissions are preventable, the researchers stressed. One of the ways readmissions can be reduced, they said, is coordinating the care among clinicians, institutions, and reimbursement structures.

6. If reimbursements were linked to provider performance and outcomes, it would be easier to assess cost-effectiveness and quality of care for non-medication interventions. COPD quality of care analyses are lagging behind other chronic diseases, the authors said.

“This report is just the beginning of a larger conversation about COPD care,” Han said, adding that this report required her to review previous findings and interview stakeholders in order to provide the industry with valuable insight. "More research is needed to help us further understand the disease and bring our patients the best treatments possible."

7. In the future, health systems should be able to identify at-risk patients at every entry point into their organizations and encourage engagement in their care plans. As patients and caregivers are engaged, the researchers wrote, they can transition smoothly through each step of their care plans.