Chronic Bronchitis And Emphysema Set To Climb
19 November 2003
Chronic Bronchitis And Emphysema Set To Climb Into Hundreds Of Thousands
The Thoracic Society of Australia and New Zealand (TSANZ) warns that COPD (chronic bronchitis and emphysema) admissions in this country are continuing to climb, often overloading hospitals in winter, and contributing to the spiralling cost of COPD, estimated at $192 million a year.
This is the major reason why TSANZ has joined with the Asthma and Respiratory Foundation in releasing ‘The Burden of COPD in New Zealand’ report, to mark World COPD Day on November 19. The report describes disturbing trends in the growth of COPD in New Zealand, caused largely by tobacco smoking, and what the health system and the Government need to do about it.
“Unfortunately not one respiratory disorder is listed amongst New Zealand’s 12 health priorities,“ says TSANZ President and Auckland respiratory physician, Associate Professor Jeff Garrett.
“This is despite the fact that over 200,000 people are estimated to have COPD in this country and the figure will increase unless we address this condition with more urgency. It remains as one of the most under-diagnosed and under-treated of all the leading causes of death.”
The impact of tobacco smoking, on the increase in those with COPD, is also being reflected internationally. COPD is now ranked by the World Health Organisation (WHO) as the fourth leading cause of death.
In association with other chest complaints (asthma, bronchiectasis, sleep related breathing disorders, pneumonia), COPD has been shown to cause more hospital admissions and deaths than either heart diseases or cancer in the United Kingdom, and similar findings could be expected in New Zealand.
“Three years ago, the WHO strongly advised governments to make respiratory disorders, and COPD in particular, a health priority, and to consider innovative approaches to management,” says Professor Garrett. “This hasn’t happened in New Zealand yet.”
TSANZ believes a comprehensive approach to the management of COPD is long overdue. Whilst a few DHBs have trialled innovative programmes with success, these have not translated into changes in practice in other DHBs. To standardise cost effective and scientifically proven care the TSANZ has developed COPD treatment guidelines for release today. If adopted they would improve quality of life in COPD patients and reduce hospital admissions.
It is of concern that a number of scientifically proven therapies in management of COPD are not currently funded in New Zealand including: rehabilitation programmes, portable oxygen therapy, long acting bronchodilators, assisted breathing devices during acute attacks of COPD and lung volume reduction surgery.
Further, programmes which provide better support for patients in the community and allow earlier diagnosis (lung function testing or spirometry) should be encouraged.