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More resources needed for COPD sufferers

Tuesday, November 15, 2016
More resources needed for COPD sufferers

Tomorrow marks World Chronic Obstructive Pulmonary Disease Day (COPD) – a condition that affects thousands of New Zealanders, yet most have never heard of it.

COPD, also known as CORD for Chronic Obstructive Respiratory Disease, is an umbrella term involving three diseases; emphysema, chronic bronchitis and asthma. In people with COPD, the airways are permanently obstructed and the tissue inside the lungs is damaged, making it hard to breathe.

Dr Felix Ram, of the School of Nursing in Massey University’s College of Health, says 15 per cent of Kiwis over 45 have the disease.

“Of these 200,000 people, nearly 30,000 New Zealanders are estimated to be living with severe COPD requiring lengthy stays in hospital, and it’s the fourth leading cause of death in New Zealand after ischaemic heart disease, stroke and lung cancer,” Dr Ram says.

Symptoms include coughing, increased phlegm and breathlessness. COPD progresses over time and while it is not curable, it can be controlled and further damage prevented. It is not fully reversible and usually occurs in people who have smoked or continue to smoke cigarettes. Exposure to irritants such as dust and fumes can also increase the risk of developing the disease.

Dr Ram is calling for urgent additional resources to be allocated towards Māori, Pacific peoples and those living in lower socio-economic areas. “Hospitalisation rates are highest for Māori, at 3.5 times the non-Māori rate and 2.2 times the rate for death. Pacific people’s hospitalisation rates are 2.8 times higher than those of other New Zealanders.

“Although COPD rates are relatively evenly spread across New Zealand, deaths in 2011 were above average in Hawke’s Bay, Lakes and Wairarapa District Health Board regions. Hospitalisation rates are 5.1 times higher in the most deprived areas than in the least deprived, and death rates are 2.7 times higher,” Dr Ram says.

A 2007 study of lung damage caused by smoking in people with the disease, conducted by Dr Ram and co-investigators from London Chest Hospital in the United Kingdom, found that once the disease was established, the damage from smoking continued even after the person quit. The research, published in the European Respiratory Journal, was the first study to show continued damage in COPD patients.

“The damage continued even 10 years after a person stopped smoking and the lung damage was no different to those patients who continued to smoke. It is vital we put resources into stopping people taking up the habit in the first place and also encourage people to quit well before any symptoms of COPD develop,” Dr Ram says.

A study of patients with asthma (one of the three components of COPD) published in the Journal of Primary Health Care in 2014 by Dr Ram and Wendy McNaughton, from Comprehensive Care Limited, showed that the use of a unique online practice- based assessment and decision support tool known as GASP (Giving Asthma Support to Patients) significantly reduced:
Hospital admissions by 33 per cent
Exacerbations by 35 per cent
Emergency department presentations by 37 per cent

Dr Ram says further data analysis reported a significant reduction in smoking, with nearly 20 per cent of patients quitting smoking as a result of using GASP.

“The GASP study reported significant improvements with Māori and Pacific populations. Our first study of the adapted GASP-COPD tool will target these population groups who have historically reported poor outcomes for respiratory illness.

“We are hoping to obtain funding to adapt the GASP tool for patients with COPD and are confident that the benefits afforded to those who use GASP, will also be available to people with COPD,” Dr Ram says.

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