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Experts Call for Re-Focussing of COPD Management to Reduce Hospital Admissions and Mortality

Lund, Switzerland, November 17 (ots/PRNewswire)

For Non-US
Medical Journalists Only
A new report on the importance of treating Chronic Obstructive
Pulmonary Disease (COPD) exacerbations is launched today, on World
COPD Day. Global dissemination of the report to family
physicians/General Practitioners around the world is being supported
and facilitated by Wonca, the World Organisation of Family Doctors.
The Time to Live Report calls for doctors to adopt guidelines and
re-prioritise their approach in COPD management. Over 90% of doctors
interviewed as part of the Time to Live Report agreed that reducing
exacerbations ("lung attacks") in COPD is vital to improve patients'
quality of life and 70% think that reducing hospital visits is
crucial.[1],[2] However, despite updated guidelines and advances in
treatment, a quarter of COPD patients hospitalised with an
exacerbation will be dead within a year[3],[4] and more than 90% of
sufferers report that exacerbations affect their daily life.[5]
Exacerbations are an acute worsening of symptoms, often triggered
by a respiratory infection, requiring medical intervention and often
hospitalisation. However, while doctors do see the need to reduce
exacerbations, when it comes to management strategies for the
condition 81% of doctors interviewed for the report still regard
every day symptomatic relief as the best treatment option. This
suggests that preventing and reducing exacerbations is still not
enough of a priority in COPD management.
Dr Alfred Loh, Chief Executive Officer of Wonca comments: "The
Time to Live Report demonstrates the need to refocus the way in which
clinicians view and treat COPD. The level of care provided to
patients with COPD, and the morbidity and mortality associated with
the condition, is truly unacceptable. We urgently need to change the
prevailing attitude that COPD is a hopeless condition with limited
treatment options. Advances in treatment and our ever-increasing
understanding of COPD means it is a condition that is both
preventable and treatable. The great news is that evidence shows
family doctors can make a huge difference to the lives of people with
COPD and their families by focussing on reducing the number and
severity of exacerbations they have to suffer."
Recommendations on how to treat COPD have been set out in
evidence-based guidelines such as those developed by the Global
Initiative for Chronic Obstructive Lung Disease (GOLD).[6] The
International Primarycare Airways Group Handbook (IPAG) Handbook,
officially launched in May 2005 at the Wonca Asia-Pacific Regional
Conference in Kyoto, Japan, also provides family doctors with
practical guidelines on the medicine-based management of COPD.
Despite acknowledgment by clinical bodies that exacerbations are a
key treatment goal for COPD, results from a recent survey included in
the Time to Live Report demonstrated a considerable difference
between targets set out in guidelines and clinical practice.
  • 90% of doctors believe reducing exacerbations is vital to improve patient's HRQoL
  • 89% agree prevention of exacerbations is key when considering choice of therapy
  • 89% agree slowing down disease progression should be the primary goal in COPD
Despite this:
  • 81% still regard symptomatic relief as the best option for treating COPD
  • One quarter of GPs are unaware of the new guidelines
  • 66% of doctors still believe patients must accept that their disease can not be managed.2
Dr John Haughney, GP in Glasgow, Scotland, Chairman of the UK
General Practice Airways Group and co-author of the Time to Live
Report, comments: "Preventing exacerbations is identified as a key
goal for the effective management of COPD, yet the Time to Live
Report reveals there is still confusion about the principal aims of
COPD management. Due to outdated beliefs about the benefits of
therapeutic interventions in COPD and a failure to implement best
practice, many patients continue to suffer unnecessarily. Reducing
the frequency and severity of exacerbations, and treating them
aggressively and effectively, is even more important than long term
symptom management, and should be the main focus of treatment if we
are to reduce the burden imposed on patients and healthcare resources
by COPD."
Professor Thys van der Molen, GP, Professor at the Department of
General Practice at the University of Groningen, Professor of Primary
Care Respiratory Medicine at the University of Aberdeen and Time to
Live Report co-author adds: "When considering therapeutic options,
doctors should focus on ensuring they recommend treatments based on
their ability to reduce the burden of exacerbations as well as
providing symptomatic relief. This strategy will eventually lead to a
better outcome since exacerbations have a negative influence on
patients' quality of life that can last up to 6 months after the
exacerbation. If we want to put the patient first, and give them the
best possible outcome, we must ensure we tackle both aspects of this
debilitating condition rather than just symptoms alone."
Traditional COPD therapies previously recommended for the
treatment of COPD, such as short-acting bronchodilators, help to
relieve acute symptoms. Recent evidence has shown treatment with both
a long-acting bronchodilator and an inhaled corticosteroid - in
particular when individual components are used in combination - not
only provides symptomatic relief, but also significantly reduces the
frequency and severity of COPD exacerbations, events which are known
to be a major contributor towards worsening of lung function.[7],[8]
Notes to Editors:
The Time to Live Report is supported by an unrestricted
educational grant from AstraZeneca. AstraZeneca are the manufacturers
of Symbicort(R), a combination of the inhaled corticosteroid
budesonide and rapid- and long-acting beta-agonist formoterol, which
is indicated for the treatment of COPD and asthma.
About Wonca
Wonca is acronym comprising the first five initials of the World
Organization of National Colleges, Academies and Academic
Associations of General Practitioners/Family Physicians. Wonca's
short name is World Organization of Family Doctors. Wonca is made up
of national colleges, academies or organizations concerned with the
academic aspects of general family practice. Beginning with 18
members in 1972, there are now 105 member organizations in 89
countries. This includes eight organizations in collaborative
relations with Wonca. In all, the total membership of the member
organizations of Wonca is over 200,000 general practitioners/family
physicians whose practices cover over 80% of the world's population.
Wonca represents and acts as an advocate for its constituent members
at an international level where it interacts with world bodies such
as the World Health Organization.
Wonca is partnering with AstraZeneca to support the distribution,
dissemination, and discussion of the Time to Live Report.
About Astrazeneca
AstraZeneca (LSE: AZN) is a major international healthcare
business engaged in the research, development, manufacture and
marketing of prescription pharmaceuticals and the supply of
healthcare services. It is one of the world's leading pharmaceutical
companies with healthcare sales of over $21.4 billion and leading
positions in sales of gastrointestinal, cardiovascular, respiratory,
oncology and neuroscience products. AstraZeneca is listed in the Dow
Jones Sustainability Index (Global) as well as the FTSE4Good Index.
References
[1] Time to Live report
[2] Synovate GP Omnibus. 250 GPs in France, Germany, Spain, UK
and Italy. Conducted April/May 2005
[3] Almagro P, Calbo E, de Echagüen AO, Barreiro B, Quintana S,
Heredia JL, Garau J. Mortality After Hospitalization for COPD. Chest
2002; 121 (5): 1441-48
[4] Wouters EF. Economic analysis of the Confronting COPD survey:
an overview of results. Respir Med. 2003 Mar; 97 Suppl C:S3-14.
[5] Vogelmeier C, Partridge MR, Stahl E. Burden of exacerbations
in COPD: the patient's perspective. Presented at the American
Thoracic Society meeting 2004
[6] Global Initiative for Chronic Obstructive Lung Disease (GOLD).
Global strategy for the diagnosis, management, and prevention of
chronic obstructive pulmonary disease: 2004 update. NHLBI/WHO
workshop report (NIH publication No. 2701). Bethesda, MD: National
Institutes of Health (NIH); 2004.
[7] Cooper CB, Tashkin DP. Recent developments in inhaled therapy
in stable chronic obstructive pulmonary disease. BMJ 2005;330;640-644
[8] Tashkin DP, Cooper CB. The role of long-acting bronchodilators
in the management of stable COPD. Chest 2004;125:249-59

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