by Livia Gamondi
In the post-emergency period, 41 percent of specialists saw an increase in patients in their clinics. And this – they say – is due to fear, anxiety about respiratory diseases and the possible consequences
Around the world, approximately 380 million people suffer from chronic obstructive pulmonary disease, COPD. Of these, 3.3 million in Italy. Over the years there has been a reduction in the age of diagnosis, which is now 50 years. Smoking is one of the main causes of the disease and the number of Italian smokers is not comforting. According to the latest 2022 report on smoking in Italy by the Istituto Superiore di Sanit, almost one in 4 Italians smokes and the number of young women is increasing. Dyspnoea, the so-called hunger for air, is one of the most common symptoms presented by patients of all degrees of severity of the disease. The positive fact is that in recent years people’s attention to the first symptoms has increased: the pandemic has made everyone aware that we are vulnerable and how important it is to take care of lung health. A survey by Doxa Pharma for GSK, recently presented in Milan, which involved 100 pulmonologists, tells us this.
In the post-emergency period, 41 percent of specialists saw an increase in patients in their clinics. And this – they say – is due to fear, anxiety about respiratory diseases and the possible consequences. In fact, the exacerbation is a decisive watershed in the decline of respiratory capacity. So much so that the international GOLD 2023 recommendations indicate prescribing the maximum therapy, the triple therapy, already after the first episode. Women are increasing, but they are also those who go to the doctor at the first symptoms (41 percent versus 11 percent of men) and follow the therapy more. And as far as smoking is concerned, they are more inclined to quit. Furthermore, (35 percent of patients vs 65 percent of males) have a shorter history of disease: 9 years compared to 12. They have a less serious condition and comorbidities: mood disorders and osteoporosis, while men suffer mainly from cardiovascular diseases and diabetes. What makes the difference is that women are more attentive to their health (62 percent vs 22 percent); to the doctor’s prescriptions and advice (39 percent compared to 21 percent), they are treated better (39 percent – 24 percent). COPD, like all chronic respiratory diseases, experiences the paradox of being among those with the most effective treatments. However, they are often taken when needed, and then left in moments of lull in the symptoms. The pandemic has therefore awakened some attention. Eight out of 10 pulmonologists confirm that Covid has brought about a change in the management and treatment of COPD patients. The biggest problems are: follow up (57 percent); referring patients to their attention (42 percent); the diagnosis (28 percent). Greater awareness or apprehension has, on the other hand, changed the doctor-patient relationship for 40 percent of those interviewed.
The patient who first asks to be reassured: 23 percent of clinicians say this; he undergoes checks more frequently (10 percent); also through telemedicine (13 percent). Today more than ever it is important to reassure patients and we have the possibility of suggesting effective treatment processes – says Professor Pierachille Santus, Director of Pneumology at the Luigi Sacco Hospital – University Center – We must change the way we think about COPD, treat the symptoms and prevent disease exacerbations. For two years we have had effective inhaled drugs which have reduced hospitalizations and allow patients to live well and longer. The question of the difficulty in booking spirometry tests, a fundamental test for the diagnosis and the patient’s path between local medicine and the specialist, remains open. Local medicine should identify patients at risk and suggest the best path – explains the expert -. If the general practitioner sees a smoking patient with a risk of COPD, he must prescribe spirometry and refer him to a specialist. It is necessary to create specific paths, use diagnostics well, prioritizing access to spirometric diagnostics for the patient with strong suspicion of COPD and activating the system so as to carry it out in a few days.
October 26, 2023 (changed October 26, 2023 | 10:00)
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