November 16, 2005
Largest-Ever COPD Study Reveals Alarming Gaps in Care
Some provinces receive failing grades, the majority 'D' or lower in Chronic Obstructive Pulmonary Disease National Report Card
The largest and most comprehensive study ever to examine Chronic Obstructive Pulmonary Disease (COPD) in Canada was released today, painting a picture of a disease with startlingly high prevalence, low awareness and no provincial or national strategies in place to manage it.
Spearheaded by The Lung Association and the Canadian Thoracic Society (CTS), Chronic Obstructive Pulmonary Disease: A National Report Card is a call to action for better COPD awareness and management across the country.
"We need to stop being polite about COPD," said Deirdre Freiheit, President and CEO of the Canadian Lung Association. "We've known for years that COPD is killing Canadians at an alarming rate, and we have the data to prove it. It's time for COPD to become a higher priority on national and provincial healthcare agendas. This report card shows there has to be a sense of urgency about it."
The rankings of the provinces show a clear deficiency in the way COPD is being managed. Most provinces receive a grade of 'D' or lower with three provinces actually failing. The report card measured public and physician awareness, access to and use of spirometry, and access to and use of non-pharmacological and pharmacological interventions. It looked at prevalence, smoking rates, hospitalization rates and access to COPD medications as per CTS guidelines. Most provinces received very low marks when ranked on "COPD as a healthcare priority."
"This Report should significantly change the way people think about this disease," said Dr. Jean Bourbeau, of the McGill University Health Center and member of the Canadian Thoracic Society. "We need a national discussion about COPD and a concerted effort to bring COPD management standards up to the levels recommended by the Canadian Thoracic Society guidelines."
Dr. Bourbeau said the report card is a call for provinces to develop strategies for management of COPD. Key programs, including smoking cessation, education, medical intervention and pulmonary rehabilitation, need to be put in place and adequately funded.
COPD - What is it?
Chronic Obstructive Pulmonary Disease, or COPD, is a respiratory disease that causes the airways of the lungs to be inflamed and become obstructed, and causes the lungs to be damaged. The two major forms of the disease are chronic bronchitis and emphysema.
Chronic bronchitis is an inflammation of the airways of the lungs that leaves them irritated. Chronic bronchitis is characterized by extra mucus that blocks those airways, resulting in a person coughing, spitting or finding it difficult to draw a breath. Emphysema damages and destroys lung tissue, resulting in the formation of large air pockets where air becomes trapped, making it difficult to draw a breath.
The main symptom of COPD is shortness of breath resulting in limitation of physical activity. Symptoms are usually insidious in onset, progressive, and characterized by frequent flare-ups and, often, hospitalization.
COPD is the fourth leading cause of death in Canada and the only leading cause of death that is increasing.
Prevalence in Canada: COPD is the fourth leading cause of death in Canada. Unlike other leading causes of death, COPD is the only disease where mortality rates continue to climb. Until now, it has been estimated that there are approximately 714,000 diagnosed patients in Canada (at the time 2.3 per cent of the population). However, eight per cent of respondents surveyed for this Report Card said they have been diagnosed with COPD, chronic bronchitis or emphysema.
Awareness: Just 17 per cent of Canadians are able to identify what COPD is, in stark contrast to other diseases such as breast cancer and HIV/AIDS, which have near universal recognition.
Management: Most provinces and territories receive low marks in their management of the disease. Although there are widely accepted Clinical Guidelines, there is a gap between real-world practice and the best practice as recommended by the CTS guidelines. For example, smoking cessation programs are not universally funded across the country. Pulmonary rehabilitation is available in most provinces but only a small fraction of Canadians with COPD have access to it and there are no provincial policies to support such programs. In some provinces patients have restricted access to the recommended first-line medications which can help treat the symptoms of the disease and keep patients out of emergency rooms.
Hospitalization Rates: Canada's ageing population is at heightened risk of developing COPD. Baby boomers grew up when smoking rates were at their peak. Despite declining smoking rates in Canada, COPD hospitalization rates are on the rise. And the trend is particularly alarming among women.
As part of this study, three different populations were surveyed. Between September 1, 2005 and October 7, 2005, telephone surveys were conducted among randomly selected, representative samples of 2,568 adult Canadians, aged 18 and over, from among the general population, 252 physicians (including 29 respirologists), and 130 COPD patients, with representative samples from each province and territory.i
The research for the Report Card was conducted by Léger Marketing, the sole Canadian representative of the Gallup International Association. Founded in 1986, Léger Marketing is the largest independent research firm in Canada.
The Report Card was directed by a Task Force established by the Canadian Lung Association and its medical arm, the Canadian Thoracic Society (CTS). It was supported through an unrestricted educational grant from Boehringer Ingelheim Canada Ltd. and Pfizer Canada Inc.
The Lung Association
For more than 100 years, The Lung Association has been the voice and primary resource for lung health in Canada. The Lung Association was first established to control the spread of tuberculosis and provide better services for tuberculosis patients. Today, we lead national and international initiatives that improve lung health through research, prevention, and education.
The work of The Lung Association is made possible through the generous support of Canadians. Our main source of funding is the Christmas Seal campaign currently under way across the country.
The Canadian Thoracic Society
The Canadian Thoracic Society (CTS) is the medical section of The Canadian Lung Association. It advises the Association on scientific matters and programs, including policies regarding support for research and professional education. The CTS provides a forum whereby medical practitioners and investigators may join in the study of lung diseases that may come within the scope of The Lung Association.
The CTS aims to maintain the highest professional and scientific standards in all aspects of respiratory diseases through leadership, education, research and communication.
Read the full text of the report:
Chronic Obstructive Pulmonary Disease: A National Report Card (PDF)
More information on COPD
For more information on the report card or to set up an interview with a spokesperson, please contact:
Director of Public Affairs
The Lung Association, National Office
(613) 569-6411 ext. 223