Chronic obstructive pulmonary disease (COPD), which includes chronic bronchitis and emphysema, is a lung disease that makes it hard to breathe — yet many people don’t know as much about it as they should.
Alarmingly, COPD is the third leading cause of death in the U.S. and one person dies every four minutes from this slow developing disease. Twelve million Americans are currently diagnosed with COPD, while an additional 12 million Americans may have the disease and remain undiagnosed[3]. However, there is good news. If COPD is diagnosed early, further worsening of the disease can be prevented and symptoms can be treated.
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Even if you’ve heard of the lung condition, chances are you may think of COPD as something that happens to frequent smokers. Although cigarette smoking contributes to the majority of COPD cases, non-smokers can get it, too, due to factors such as increased genetic risk, childhood infections that predispose them to COPD, and air and occupational exposures.
People with COPD have better control over their condition and better health in general if it is identified early. Precise, early diagnosis along with ongoing monitoring and consistent treatment will slow the progression of the disease and have a significant impact on the quality of life for these patients.
Lung screenings can identify COPD before a major loss of lung function occurs, but most people are still diagnosed in a lung function lab. This testing often comes too late when significant, irreversible lung damage has already occurred.
Spirometry as the Gold Standard
COPD may be confused with other lung diseases on the basis of symptoms, but treatment for COPD and for asthma, for example, is different.
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The symptoms of COPD, such as coughing, respiratory infections, shortness of breath, body fatigue and chest tightness, are slow and subtle to develop. Patients often do not pay close attention to their developing symptoms or think that they are not breathing normally because they are overweight or aging. That makes it all the more important for patients to have a breathing test that measures lung function, known as spirometry.
The Global Initiative for Obstructive Lung Disease (GOLD) guidelines recommend spirometry as one of the primary tools to establish a COPD diagnosis in patients with a historic cough, difficulty breathing or exposures to risk factors, such as smoking. While spirometry is known and widely available, these pulmonary function tests continue to be underutilized.
Spirometry helps find the presence of the obstruction since the obstruction occurs in COPD before symptoms develop. Other pulmonary function tests, such as diffusion lung capacity (DLCO) and measurement of lung volumes, can provide additional information about the overall impact of the disease, and can be valuable in resolving diagnostic uncertainties.
In addition, DLCO testing is the most powerful predictor of survival in COPD patients. It measures the ability of the lungs to transfer gas from inhaled air to the red blood cells in pulmonary capillaries.
Acting as a one-two punch, spirometry and a DLCO test allow for earlier detection of lung disease, creating differential diagnosis from COPD to asthma to cardiovascular disease, and deciding the correct decision for immediate start of treatment at the point of care.
Implementing Routine Spirometry
Lung function technology has advanced dramatically over the years making the equipment much more intuitive for healthcare providers to use and implement into EHR systems.
Outdated, conventional lung function equipment is being replaced with portable and maintenance-free devices such as spirometry and DLCO for measuring lung function at the point of care.
The benefit of this modern approach is that it standardizes test results regardless of where the patient is tested, something that was not true with older equipment. In addition to being able to quickly test patients at the point of care, these modern devices can reduce wait times, decrease misdiagnosis and specialty referral costs.
The Future of Diagnosing and Managing COPD
With the World Health Organization predicting that COPD will become the third leading cause of death worldwide by 2030, it is critical that healthcare providers receive the proper education and understanding of the tools that are readily available at their fingertips.
Cost-effective, easy-to-use tools, like spirometers and portable DLCO systems, need to be implemented as the standard similar to a blood pressure test in PCPs’ offices and other locations where people receive their care. With patient-centric care being at the heart of healthcare professionals’ work, they must adapt to these tools for earlier detection and diagnosis of this life-threatening disease, guaranteeing a better life for COPD patients.
The good news remains that COPD awareness, modern diagnostic tools and the appropriate care plan can help people with COPD continue to live an active life.
Wendy is a 1992 graduate of the Adult Primary Care Nurse Practitioner program at Simmons College in Boston, Massachusetts and completed a family nurse practitioner post-Master’s program in 1995. She is an adult and family nurse practitioner and the owner of two, nurse practitioner owned and operated clinics within New Hampshire named: Wright & Associates Family Healthcare. In addition, she is the owner of Partners in Healthcare Education, a medical education company. She is the Past President of NPACE and the Senior lecturer for Fitzgerald Health Education Associates. She is the recipient of numerous awards and was chosen by the American Association of Nurse Practitioners as the 1999 recipient of the New Hampshire State Excellence Award. In addition, she received the 2009 NH Nurse Practitioner of the Year and the 2014 Top 5 Women in New Hampshire Business Award. In 2005, she was inducted as a Fellow into the American Academy of Nurse Practitioners; in October 2014, a Fellow in the
American Academy of Nursing, and in March 2017, a Fellow into the National Academies of Practice. She is the founder of the NH Chamber of Entrepreneurial Nurse Practitioners, an organization designed to assist nurse practitioners with independent practice issues. In addition to full-time clinical practice, she presents nationally to different audiences and has been a speaker at over 1000 conferences in 46 states. She is the nurse practitioner representative to the State of NH Immunization Advisory Board. She has been a medical media spokesperson for a number of companies and has appeared on radio, television, and in print magazines. Wendy is frequently consulted by malpractice attorneys around the area of clinical practice and has worked on more than 100 malpractice cases involving nurses and nurse practitioners.
Georg Harnoncourt has been CEO of ndd Medical Technologies, a leader in
pulmonary function testing with products based on proprietary breakthrough TrueFlow ultrasound technology, since 2002. Prior to holding the position of CEO, Georg started in business development, where he focused on the U.S. market and built an experienced sales team. Since joining ndd in 1996, Georg has been responsible for transitioning the company from a research startup to a market leader with over 45% market share in spirometry in the United States. A member of the founding family, Georg helped bring the vision of earlier diagnosis of lung disease to reality by developing products focused on the patient at the point of care.
Born in Graz, Austria, Georg graduated with a degree economics and business at Vienna University where he studied economics and business. He currently lives in Switzerland.
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