Experts say diagnosing asthma, COPD early is crucial.
- Researchers
report that as many as 70% of people with chronic obstructive pulmonary
disease (COPD) or asthma could be undiagnosed.
- They say that receiving a diagnosis and
treatment can dramatically improve health and quality of life for a person
with one of those conditions.
- They add the people should take respiratory
symptoms seriously and consult a physician and request a spirometry test
if they’re concerned.
Next time you go to the
doctor, maybe ask them to check your breathing — especially if you’ve been
experiencing even minor trouble.
Nearly seven out of 10
people with asthma or chronic
obstructive pulmonary disease (COPD) are undiagnosed, a
situation that can lead to worse long-term health outcomes and lower quality of
life than if a person had received diagnosis and treatment earlier, a new study published in the New England
Journal of Medicine reports.
This research is the first
of its kind to look at not only rates of diagnosis for asthma and COPD but also
to detail the effects of early treatment and diagnosis on quality of life and
health system burden.
“I’m a practicing
pulmonologist and I see a lot of people who come to my office who’ve
experienced symptoms of asthma or COPD for months to years, and the diagnosis
hasn’t been made,” Dr. Shawn Aaron, a lead study author as well as
a respirologist and senior scientist at the Ottawa Hospital Research Institute
and a professor at the University of Ottawa in Canada, told Medical News
Today.
“So we did this study where
we looked at people who were who we diagnosed with no previous history of
asthma or COPD and we diagnosed them,” he explained. “We found that compared to
people their age, those who are undiagnosed with COPD or asthma have a much
worse quality of life. They have impaired work performance and impaired work
attendance because they’re taking days off because of their respiratory
symptoms. These are people that are suffering sort of silently because they’re
not they’re either not seeing their doctors or their doctors are not doing the
proper diagnosis.”
Details from
the asthma, COPD diagnosis study
Researchers
surveyed more than 26,000 people about shortness of breath and lung function to
find a group of 595 asthma and COPD diagnoses, which were confirmed using a
gold-standard spirometry test.
Of this group, 508 agreed
to participate in a clinical study where half received typical clinical care
for these conditions and the other half had regular visits with a lung specialist.
Both groups received help
with 92% of those seeing lung specialists receiving new medications to treat
the conditions as well as 60% of those who received usual care.
Those who saw lung
specialists took fewer trips to the doctor in the following year (0.53 compared
to 1.12 per participant) and had larger improvements on the St. George’s Respiratory Questionnaire (10
point increase compared to less than 7) when compared to their counterparts
receiving usual care.
Researchers reported that
both groups also improved far more than if they had remained undiagnosed. They
said a four-point improvement on the respiratory questionnaire represents a significant
increase in health and quality of life, which each study group experienced.
“Overall, these results are
inspiring,” said Dr. Robert Jasmer, a
pulmonologist at Pulmonary Associates of Burlingame in California who was not
involved in the research.
“Given the specialized
training and experience that we as pulmonologists have with patients who have
asthma and COPD, it was nice to see the benefits of diagnosis and early treatment
confirmed in a community-based study published in a prestigious medical
journal,” Jasmer told Medical News Today.
Why people with COPD and
asthma go undiagnosed
On
some level, the findings of this study are common sense. Of course, people with
an undiagnosed medical condition do better after receiving a diagnosis.
However, beneath that is
the more probing question of just why so many people go undiagnosed with
serious respiratory illnesses.
The answer is
multi-faceted, but one reason, especially where COPD is concerned, is that it
tends to hit people later in life, which can make the symptoms easier to ignore
until they progress to a state that’s undeniable, according to Aaron.
“You don’t usually start
developing COPD until you’re in your sixties,” he said. “Many people who start
developing COPD become more and more short of breath, and the shortness of
breath is progressive, and they decline with more shortness of breath every
month or two or three. Maybe they’re in denial or just figure that they’re getting
older.”
Physicians can also
perpetuate this dynamic.
“Sometimes the doctor will
wave away the symptoms and the complaints and say, ‘Oh, yeah, well, you’re 65
now, we expect you to be a little short of breath,’” Aaron said. “Sometimes the
doctor has good intentions but doesn’t make the diagnosis.”
How to talk
to your doctor about COPD, asthma
Patient
self-advocacy can help.
“If you’re experiencing
prolonged cough, it doesn’t go away after eight weeks, or you’re experiencing
wheezing or chest tightness — this is not normal. And you shouldn’t assume that
everything is fine,” Aaron said. “You should go to your physician and you should
insist on the physician ordering a spirometry test for you. What I would tell
the public because we now know that if we find this and we treat it, you will
get better.”
Jasmer echoed that
sentiment.
“This study is important
because there has been a lot of negativity for most of my education and career
around COPD, especially as being an end-stage and hopeless disease for which
treatment is not helpful-that is not correct, so COPD particularly suffers from
a major PR problem,” he said. “Public perceptions about COPD being untreatable
are not true and asthma is almost entirely treatable and usually completely
reversible. While patients with COPD can help their symptoms with lifestyle
changes such as quitting smoking and exercising, there are still many other
effective medical treatments available that they can discuss with their doctor
to further improve their symptoms, which will also improve their quality of
life.”
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