Understanding COPD - Recent Research and the Evolving Definition of COPD for MNACVPR

Size: px
Start display at page:

Download "Understanding COPD - Recent Research and the Evolving Definition of COPD for MNACVPR"

Transcription

1 Understanding COPD - Recent Research and the Evolving Definition of COPD for MNACVPR by Scott Cerreta, BS, RRT Director of Education scerreta@copdfoundation.org

2 CONFLICT OF INTEREST I have no financial conflict of interest that relates to this presentation. Any use of brand names is not in any way meant to be an endorsement of a specific product, but to merely illustrate a point of emphasis.

3 OBJECTIVES 1. Discuss current literature and research that warrants the need to change COPD definitions and guidelines. 2. Describe current research that challenges the current definition of COPD today and treating patients with seven severity domains. 3. Describe concepts of mild-copd, early-copd and pre-copd. 4. Identify how these changes will someday impact future diagnosis and treatment recommendations.

4 NHLBI DEFINITION Chronic Obstructive Pulmonary Disease Serious lung disease that over time makes it hard to breathe Emphysema Chronic Bronchitis Blocked (obstructed) airways make it hard to get air in and out

5 COPDF DEFINITION Chronic Obstructive Pulmonary Disease Serious lung disease that over time makes it hard to breathe Emphysema Chronic Bronchitis Refractory Asthma and Some forms of bronchiectasis Blocked (obstructed) airways make it hard to get air in and out

6 GOLD DEFINITION COPD, a common preventable and treatable disease, is characterized by persistent airflow limitation that is usually progressive and associated with an enhanced chronic inflammatory response in the airways and the lung to noxious particles or gases. Exacerbations and comorbidities contribute to the overall severity in individual patients. Alpha-1 testing for young and/or low tobacco use or environmental exposures

7 ATS, ERS, ACP, ACCP STATEMENT Chronic Obstructive Pulmonary Disease (COPD) is a preventable and treatable disease state characterised by airflow limitation that is not fully reversible. The airflow limitation is usually progressive and associated with an abnormal inflammatory response of the lungs to noxious particles or gases, primarily caused by cigarette smoking. Alpha-1 testing for all with diagnosed COPD

8 COPD: DEFINITIONS OF 21ST CENTURY Chronic bronchitis Emphysema Preventable and treatable Airflow limitation that is not fully reversible Progressive disease Abnormal inflammatory response of the lungs Subsets of patients COPD Asthma Box = FEV1/FVC < 70% or < LLN American Thoracic Society European Respiratory Society: Standards for the Diagnosis and Management of Patients with COPD, download manual:

9 4L 3L 2L Pre COPD Normal- Small vs. Abnormal Mild COPD 50 y/o FEV1 65%p 55 y/o FEV1 40%p 10-15ml/yr 15-25ml/yr 1L Early COPD Active Disease 40-80ml/yr Inactive Disease

10 EVOLUTION OF UNDERSTANDING COPD Where were we? Physiology Registries Where are we? Current Research COPDGene SPIROMICS Registries Where are we going? Patient Powered Research Networks Genetic phenotyping Stem Cell Therapy

11 Spiromics Dr Rennard Identifying subsets of people with COPD Why do some COPD patients respond to treatment while others do not? Collection & analysis of phenotypic, biomarker, genetic, genomic, and clinical data from subjects with COPD 3,200 subjects CURRENT RESEARCH COPDGene Dr. Crapo Why do some smokers get COPD while others don t Are there different types of COPD Using HRCT and identified a large number of people with emphysema despite normal spirometry 10,300 subjects

12 COPDGENE At least 10 pack-years of cigarette smoking Spirometry that meets one of four Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages or normal (FEV1 greater than 80% of predicted level and forced expiratory volume in 1 second/forced vital capacity [FEV1/FVC] greater than 0.7) No Grade U Inclusion Criteria Self-designation of non-hispanic white or African- American

13 COPDGENE GOLD 4 NO EMPHYSEMA GOLD 0 (FEV1 =90%) 5% Emphysema

14 FEV 1 /FVC Ratio Distribution of Subjects in the COPDGene Cohort GOLD U Normal GOLD 4 GOLD 3 GOLD 2 GOLD 1 FEV 1 (percent predicted)

15 Number of Subjects COPDGene COPD Distribution by Age n=10,300 GOLD 2-4 GOLD U/1 GOLD Age

16 Number of Subjects COPDGene COPD Distribution by Age 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Age GOLD 2-4 GOLD U/1 GOLD 0

17 Smokers Without Obstruction (GOLD 0) Are they really normal? Chronic Airway Obstruction (FEV1 & FEV1/FVC) Dyspnea (MMRC Dyspnea Score) Exercise Capacity (6 MW) Emphysema (CT) Gas Trapping (Expiratory CT) Exacerbations (Antibiotics/Steroids/Hosp) Co-morbidities (CVD, Osteo, Depression +)

18 Percent Subclinical Obstruction in Normal Smokers COPDGene GOLD 0 Subjects = FEV1 % Predicted

19 Looking for Sick Smokers in the COPDGene GOLD 0 Cohort BODE > 1 6 MW < 1350 ft. MMRC dyspnea score 2 SGRQ 28 Chronic bronchitis symptoms (cough and sputum) Emphysema > 5% by CT (% HU < -950) Gas trapping > 15% by expiratory CT (% HU < -856) History of one or more exacerbations in prior year

20 COPDGene: GOLD 0 Sick Smokers (one or more signs/symptoms) 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Age One or More Signs or Symptoms No Signs or Symptoms

21 COPD A HETEROGENIOUS DISEASE

22 COPD HETEROGENEITY PT # 1 58 y FEV1: 28 % MRC: 2/4 PaO2: 70 mmhg 6MWD: 540 m BMI: 30 PT # 2 62 y FEV1: 33% MRC: 2/4 PaO2: 57 mmhg 6MWD: 400 m BMI: 21 PT # 3 69 y FEV1: 35% MRC: 3/4 PaO2: 66 mmhg 6MWD: 230 m BMI: 34 PT # 4 Cote & Celli 72 y FEV1: 34% MRC: 4/4 PaO2: 60 mmhg 6MWD: 154 m BMI: 24

23 COPD PHENOTYPING WITH CT SCANS Low Dose HRCT used in Lung CA screening Jan 1, Medicare Gets annual LDCT USPSTF Grade B Huge win for Lung Health and COPD! y/o with 30+ pack year smoking Current or previous smoker that quit <15yrs ago

24 SCENARIOS Green = Normal Yellow = fsad (functional small airways disease) Red = Emphysema

25 PARAMETRIC RESPONSE MAPPING (PRM)

26 COPD DISEASE PROGRESSION COPDGene limited to CTs every 5 years COPDGene followed groups of patients not individuals Secondary Study evaluated a trial in 194 patients #1 GOLD 4, FEV1=18%@0, 17%@11m #2 GOLD 2, FEV1=66%@0, 75%@26m Identified that fsad precludes emphysema

27 PRM FOR INDIVIDUALS Secondary Study evaluated a trial in 194 patients A GOLD 4, FEV1=18%@0, 17%@11m B GOLD 2, FEV1=66%@0, 75%@26m

28 Despite being the third leading cause of death in the United States, there is very little funding for COPD. COPD is presentable and treatable but the lack of research, awareness and education has resulted in millions of unnecessary hospitalizations, complications and deaths.

29 PATIENT CENTERED OUTCOMES RESEARCH INSTITUTE Independent research organization authorized by Congress as part of the 2010 Patient Protection and Affordable Care Act Fund comparative clinical effectiveness research that provides patients and their caregivers the information they need to make better informed health care decisions

30 COPD FOUNDATION PCORI PROJECTS PELICAN: comparative effectiveness of a PEer-Led O 2 Infoline for patients and CAregivers - evaluate whether a peer-led O 2 infoline for patients and caregivers will increase adherence to oxygen prescription and improve health in patients with COPD discharged from the hospital with an oxygen prescription PArTNER: PATient Navigator to reduce Readmissions - focuses on developing and testing a program that combines a community health worker (lay patient advocate, acting as a "Patient Navigator") and a peer-led telephone support line to increase social support, improve self-efficacy and decrease post-discharge acute care use. ClinicalTrials.gov

31 PELICAN FLIER We need your help Oxygen coaching Anyone with 24/7 oxygen use Be part of the future discoveries in COPD through research

32 Empowering Patients through Research You might have lost your breath, but you haven t lost your voice

33 COPD360SOCIAL & INFOLINE

34 More patient focused COPD research is the answer to finding more effective therapies and eventually cures to help the millions of COPD patients.

35 By joining the COPD PPRN we have nothing to lose and everything to gain. After registering I felt as though I was a part of a major breakthrough for COPD. Registering for the PPRN is an opportunity for me to contribute to the body of research that may make the key discovery that leads to the cure. Being a part of this program is very empowering and makes me feel like I m doing my part to help.

36 YOU CAN HELP! Request postcards to share at support groups, clinics, respirator care departments, etc Posters and paper surveys available for some locations.

37 SUMMARY 1. Implications for treatment of COPD is ever evolving based on the evidence. 2. COPD is involved with several studies and has many programs to improve quality of life for people living with COPD. 3. LDCT lung cancer screening is a win for lung health and COPD early dx. 4. Patients have the power in finding cures. Join the Patient Powered Research Network (PPRN).

38

9/22/2015 CONFLICT OF INTEREST OBJECTIVES. Understanding COPD - Recent Research and the Evolving Definition of COPD for MNACVPR

9/22/2015 CONFLICT OF INTEREST OBJECTIVES. Understanding COPD - Recent Research and the Evolving Definition of COPD for MNACVPR Understanding COPD - Recent Research and the Evolving Definition of COPD for MNACVPR by Scott Cerreta, BS, RRT Director of Education www.copdfoundation.org scerreta@copdfoundation.org CONFLICT OF INTEREST

More information

Clinical and radiographic predictors of GOLD-Unclassified smokers in COPDGene

Clinical and radiographic predictors of GOLD-Unclassified smokers in COPDGene Clinical and radiographic predictors of GOLD-Unclassified smokers in COPDGene Emily S. Wan, John E. Hokanson, James R. Murphy, Elizabeth A. Regan, Barry J. Make, David A. Lynch, James D. Crapo, Edwin K.

More information

Asthma COPD Overlap (ACO)

Asthma COPD Overlap (ACO) Asthma COPD Overlap (ACO) Dr Thomas Brown Consultant Respiratory Physician Thomas.Brown@porthosp.nhs.uk Dr Hitasha Rupani Consultant Respiratory Physician Hitasha.rupani@porthosp.nhs.uk What is Asthma

More information

2/4/2019. GOLD Objectives. GOLD 2019 Report: Chapters

2/4/2019. GOLD Objectives. GOLD 2019 Report: Chapters GOLD Objectives To provide a non biased review of the current evidence for the assessment, diagnosis and treatment of patients with COPD. To highlight short term and long term treatment objectives organized

More information

Chronic Obstructive Pulmonary Disease Guidelines and updates

Chronic Obstructive Pulmonary Disease Guidelines and updates Chronic Obstructive Pulmonary Disease Guidelines and updates October 20, 2018 Saratoga Springs, NY COPD (Chronic obstructive pulmonary disease) is a major cause of mortality and morbidity in the United

More information

Supplementary Online Content

Supplementary Online Content Supplementary Online Content Regan EA, Lynch DA, Curran-Everett D, et al; Genetic Epidemiology of COPD (COPDGene) Investigators. Clinical and radiologic disease in smokers with normal spirometry. Published

More information

Update on heterogeneity of COPD, evaluation of COPD severity and exacerbation

Update on heterogeneity of COPD, evaluation of COPD severity and exacerbation Update on heterogeneity of COPD, evaluation of COPD severity and exacerbation Yung-Yang Liu, MD Taipei Veterans General Hospital Aug 29, 2015 G O lobal Initiative for Chronic bstructive L D ung isease

More information

SGRQ Questionnaire assessing respiratory disease-specific quality of life. Questionnaire assessing general quality of life

SGRQ Questionnaire assessing respiratory disease-specific quality of life. Questionnaire assessing general quality of life SUPPLEMENTARY MATERIAL e-table 1: Outcomes studied in present analysis. Outcome Abbreviation Definition Nature of data, direction indicating adverse effect (continuous only) Clinical outcomes- subjective

More information

CHRONIC OBSTRUCTIVE PULMONARY DISEASE

CHRONIC OBSTRUCTIVE PULMONARY DISEASE CHRONIC OBSTRUCTIVE PULMONARY DISEASE Chronic Obstructive Pulmonary Disease (COPD) is a slowly progressive disease of the airways that is characterized by a gradual loss of lung function. In the U.S.,

More information

Bode index as a predictor of severity in patients with chronic obstructive pulmonary disease.

Bode index as a predictor of severity in patients with chronic obstructive pulmonary disease. IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-issn: 2279-0853, p-issn: 2279-0861.Volume 15, Issue 5 Ver. VII (May. 2016), PP 93-100 www.iosrjournals.org Bode index as a predictor of severity

More information

OPTIMIZING MANAGEMENT OF COPD IN THE PRACTICE SETTING 10/16/2018 DISCLOSURES I have no financial or other disclosures

OPTIMIZING MANAGEMENT OF COPD IN THE PRACTICE SETTING 10/16/2018 DISCLOSURES I have no financial or other disclosures OPTIMIZING MANAGEMENT OF COPD IN THE PRACTICE SETTING J. Michael Fuller, MD, MEd, FACP, FCCP Associate Professor of Medicine University of South Carolina Greenville DISCLOSURES I have no financial or other

More information

COPD: Current Medical Therapy

COPD: Current Medical Therapy COPD: Current Medical Therapy Angela Golden, DNP, FNP-C, FAANP Owner, NP from Home, LLC Outcomes As a result of this activity, learners will be able to: 1. List the appropriate classes of medications for

More information

Chronic Obstructive Pulmonary Disease (COPD).

Chronic Obstructive Pulmonary Disease (COPD). Chronic Obstructive Pulmonary Disease (COPD). Linde: Living healthcare 02 03 Chronic Obstructive Pulmonary Disease (COPD). A pocket guide for healthcare professionals. COPD the facts Moderate to severe

More information

This is a cross-sectional analysis of the National Health and Nutrition Examination

This is a cross-sectional analysis of the National Health and Nutrition Examination SUPPLEMENTAL METHODS Study Design and Setting This is a cross-sectional analysis of the National Health and Nutrition Examination Survey (NHANES) data 2007-2008, 2009-2010, and 2011-2012. The NHANES is

More information

People with asthma who smoke. The combination of asthma, a chronic airway disease, and smoking increases the risk of COPD even more.

People with asthma who smoke. The combination of asthma, a chronic airway disease, and smoking increases the risk of COPD even more. COPD Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disease that causes obstructed airflow from the lungs. Symptoms include breathing difficulty, cough, sputum (phlegm) production

More information

ASTHMA-COPD OVERLAP SYNDROME 2018: What s All the Fuss?

ASTHMA-COPD OVERLAP SYNDROME 2018: What s All the Fuss? ASTHMA-COPD OVERLAP SYNDROME 2018: What s All the Fuss? Randall W. Brown, MD MPH AE-C Association of Asthma Educators Annual Conference July 20, 2018 Phoenix, Arizona FACULTY/DISCLOSURES Randall Brown,

More information

Bridges to Excellence Chronic Obstructive Pulmonary Disease Care Recognition Program Guide

Bridges to Excellence Chronic Obstructive Pulmonary Disease Care Recognition Program Guide Bridges to Excellence Chronic Obstructive Pulmonary Disease Care Recognition Program Guide Altarum Bridges to Excellence 3520 Green Court, Suite 300 Ann Arbor, MI 48105 bte@altarum.org www.bridgestoexcellence.org

More information

What do pulmonary function tests tell you?

What do pulmonary function tests tell you? Pulmonary Function Testing Michael Wert, MD Assistant Professor Clinical Department of Internal Medicine Division of Pulmonary, Critical Care, and Sleep Medicine The Ohio State University Wexner Medical

More information

Online Data Supplement. Prevalence of Chronic Obstructive Pulmonary Disease in Korea: Results of a Population-based Spirometry Survey

Online Data Supplement. Prevalence of Chronic Obstructive Pulmonary Disease in Korea: Results of a Population-based Spirometry Survey Online Data Supplement Prevalence of Chronic Obstructive Pulmonary Disease in Korea: Results of a Population-based Spirometry Survey Dong Soon Kim, MD, Young Sam Kim MD, Kee Suk Chung MD, Jung Hyun Chang

More information

COPD or not COPD, that is the question.

COPD or not COPD, that is the question. COPD or not COPD, that is the question. Asthma-COPD Overlap Syndrome: ACOS Do we really need this? Michelle Harkins Disclosure Slide Slide help - William Busse, MD Organizational Interests ATS, ACCP, ACP

More information

How to treat COPD? What is the mechanism of dyspnea? Smoking cessation

How to treat COPD? What is the mechanism of dyspnea? Smoking cessation : The Increasing Role of the FP Alan Kaplan, MD, CCFP(EM) Presented at the Primary Care Today: Education Conference and Medical Exposition, Toronto, Ontario, May 2006. Chronic obstructive pulmonary disease

More information

Management of Acute Exacerbations of COPD

Management of Acute Exacerbations of COPD MiCMRC Educational Webinar Management of Acute Exacerbations of COPD August 22, 2018 MiCMRC Educational Webinar Management of Acute Exacerbations of COPD Expert Presenter: Catherine A. Meldrum PhD RN MS

More information

Decramer 2014 a &b [21]

Decramer 2014 a &b [21] Buhl 2015 [19] Celli 2014 [20] Decramer 2014 a &b [21] D Urzo 2014 [22] Maleki-Yazdi 2014 [23] Inclusion criteria: Diagnosis of chronic obstructive pulmonary disease; 40 years of age or older; Relatively

More information

Productivity losses in chronic obstructive pulmonary disease a population-based survey.

Productivity losses in chronic obstructive pulmonary disease a population-based survey. Online supplement to Productivity losses in chronic obstructive pulmonary disease a population-based survey. Running head: Productivity losses in COPD. Authors: Marta Erdal, Department of Thoracic Medicine,

More information

Disclosure and Conflict of Interest 8/15/2017. Pharmacist Objectives. At the conclusion of this program, the pharmacist will be able to:

Disclosure and Conflict of Interest 8/15/2017. Pharmacist Objectives. At the conclusion of this program, the pharmacist will be able to: Digging for GOLD Rebecca Young, PharmD, BCACP, Roosevelt University College of Pharmacy Assistant Professor of Clinical Sciences Practice Site Advocate Medical Group-Nesset Pavilion Disclosure and Conflict

More information

Epidemiology of COPD Prof. David M. Mannino, M.D.

Epidemiology of COPD Prof. David M. Mannino, M.D. Epidemiology of COPD David M. Mannino, M.D. Professor Department of Preventive Medicine and Environmental Health College of Public Health University of Kentucky 1 Outline Definitions Severity Progression

More information

RESPIRATORY PHYSIOLOGY Pre-Lab Guide

RESPIRATORY PHYSIOLOGY Pre-Lab Guide RESPIRATORY PHYSIOLOGY Pre-Lab Guide NOTE: A very useful Study Guide! This Pre-lab guide takes you through the important concepts that where discussed in the lab videos. There will be some conceptual questions

More information

Objectives. Advances in Managing COPD Patients

Objectives. Advances in Managing COPD Patients 4:45 5:30pm Advances in Managing Patients SPEAKER Nicola Hanania, MD, FCCP, FRCP, FACP Presenter Disclosure Information The following relationships exist related to this presentation: Nicola Hanania, MD,

More information

Parametric response mapping

Parametric response mapping Parametric response mapping Utility of a novel imaging biomarker in pulmonary disease Dharshan Vummidi MD, Lama VN MD, Yanik G MD, Kazerooni EA MD, Meilan Han MD, Galban C PhD Radiology, Pulmonary & Critical

More information

Fact. Objectives 1/6/2016. Reducing Hospital Readmissions for Chronic Obstructive Pulmonary Disease (COPD)

Fact. Objectives 1/6/2016. Reducing Hospital Readmissions for Chronic Obstructive Pulmonary Disease (COPD) Reducing Hospital Readmissions for Chronic Obstructive Pulmonary Disease (COPD) Jin S. Oh, PharmD Larkin Community Hospital January 10, 2016 Fact COPD is the third leading cause of death in the United

More information

National COPD Audit Programme

National COPD Audit Programme National COPD Audit Programme Planning for every breath National Chronic Obstructive Pulmonary Disease (COPD) Audit Programme: Primary care audit (Wales) 2015 17 Data analysis and methodology Section 2:

More information

2018 OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY ONLY. MEASURE TYPE: Process

2018 OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY ONLY. MEASURE TYPE: Process Quality ID #52 (NQF 0102): Chronic Obstructive Pulmonary Disease (COPD): Long-Acting Inhaled Bronchodilator Therapy National Quality Strategy Domain: Effective Clinical Care 2018 OPTIONS FOR INDIVIDUAL

More information

Defining COPD. Georgina Grantham Community Respiratory Team Leader/ Respiratory Nurse Specialist

Defining COPD. Georgina Grantham Community Respiratory Team Leader/ Respiratory Nurse Specialist Defining COPD Georgina Grantham Community Respiratory Team Leader/ Respiratory Nurse Specialist Defining COPD Chronic Obstructive Pulmonary Disease (COPD) is a common, preventable and treatable disease

More information

Anyone who smokes and/or has shortness of breath and sputum production could have COPD

Anyone who smokes and/or has shortness of breath and sputum production could have COPD COPD DIAGNOSIS AND MANAGEMENT CHECKLIST Anyone who smokes and/or has shortness of breath and sputum production could have COPD Confirm Diagnosis Presence and history of symptoms: Shortness of breath Cough

More information

Lung Cancer Screening: Benefits and limitations to its Implementation

Lung Cancer Screening: Benefits and limitations to its Implementation Lung Cancer Screening: Benefits and limitations to its Implementation Rolando Sanchez, MD Clinical Assistant Professor Pulmonary-Critical Care Medicine University of Iowa Lung cancer - Epidemiology Cancer

More information

Around-COPD Verona (Italy), January Highlights

Around-COPD Verona (Italy), January Highlights Introduction Around-COPD Verona (Italy), January 18 2017 Highlights Prof. Dal Negro chairman of the symposium, opened the congress by highlighting the burden of COPD as a chronic invalidating disease affecting

More information

COPD: early detection, screening and case-finding: what is the evidence? Prof. Jan-Willem Lammers, Md PhD Department of Respiratory Diseases

COPD: early detection, screening and case-finding: what is the evidence? Prof. Jan-Willem Lammers, Md PhD Department of Respiratory Diseases COPD: early detection, screening and case-finding: what is the evidence? Prof. Jan-Willem Lammers, Md PhD Department of Respiratory Diseases «If you test one smoker with cough every day You will diagnose

More information

Current status & future mission for chronic obstrutive airway diseases (COAD) in Asia

Current status & future mission for chronic obstrutive airway diseases (COAD) in Asia Current status & future mission for chronic obstrutive airway diseases (COAD) in Asia Sang-Do Lee, M.D., Ph.D. Division of Pulmonary & Critcal Care Med Asan Medical Center College of Med, Univ. of Ulsan

More information

2018 OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY ONLY. MEASURE TYPE: Process

2018 OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY ONLY. MEASURE TYPE: Process Quality ID #51 (NQF 0091): Chronic Obstructive Pulmonary Disease (COPD): Spirometry Evaluation National Quality Strategy Domain: Effective Clinical Care 2018 OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY ONLY

More information

Karen Meyerson, MSN, APRN, NP-C, AE-C Director, Commercial Care Management Priority Health

Karen Meyerson, MSN, APRN, NP-C, AE-C Director, Commercial Care Management Priority Health Webinar for Michigan Center for Clinical Systems Improvement (Mi-CCSI) November 29, 2017 Karen Meyerson, MSN, APRN, NP-C, AE-C Director, Commercial Care Management Priority Health Top 5 Causes of Death

More information

Respiratory diseases in Ostrołęka County

Respiratory diseases in Ostrołęka County Respiratory diseases in Ostrołęka County 4400 persons underwent examination 950 persons were given referrals to more detailed investigation 600 persons were examined so far The results of more detailed

More information

10/27/15. Presenter Disclosures. Objec4ve. Winston Liao. 143 rd Annual APHA. Winston Liao. No relationships to disclose

10/27/15. Presenter Disclosures. Objec4ve. Winston Liao. 143 rd Annual APHA. Winston Liao. No relationships to disclose Winston Liao 143 rd Annual APHA November 3, 2015 Presenter Disclosures Winston Liao No relationships to disclose Objec4ve Ø Describe the public health burden of COPD from a data perspective Present epidemiologic

More information

What s new in COPD? Apichart Khanichap MD. Department of Medicine, Faculty of Medicine, Thammasat university

What s new in COPD? Apichart Khanichap MD. Department of Medicine, Faculty of Medicine, Thammasat university What s new in COPD? Apichart Khanichap MD. Department of Medicine, Faculty of Medicine, Thammasat university Management stable COPD Relieve symptoms Improve exercise tolerance Improve health status Prevent

More information

COPD exacerbation. Chiara Maruggi, PGY2

COPD exacerbation. Chiara Maruggi, PGY2 COPD exacerbation Chiara Maruggi, PGY2 Learning objectives At the end of this lecture students will be able to: 1) Critically assess patients for COPD and design a management plan. 2) Develop a step-wise

More information

MEDICAL STUDENT INVOLVEMENT IN ASSESSING RESPIRATORY SYMPTOMS TO IMPROVE EARLY DETECTION OF LUNG DISEASE IN HIV PATIENTS.

MEDICAL STUDENT INVOLVEMENT IN ASSESSING RESPIRATORY SYMPTOMS TO IMPROVE EARLY DETECTION OF LUNG DISEASE IN HIV PATIENTS. MEDICAL STUDENT INVOLVEMENT IN ASSESSING RESPIRATORY SYMPTOMS TO IMPROVE EARLY DETECTION OF LUNG DISEASE IN HIV PATIENTS Simone Neri Definition of COPD COPD, a common preventable and treatable disease,

More information

Chronic Obstructive Pulmonary Disease (COPD) KAREN ALLEN MD PULMONARY & CRITICAL CARE MEDICINE VA HOSPITAL OKC / OUHSC

Chronic Obstructive Pulmonary Disease (COPD) KAREN ALLEN MD PULMONARY & CRITICAL CARE MEDICINE VA HOSPITAL OKC / OUHSC Chronic Obstructive Pulmonary Disease (COPD) KAREN ALLEN MD PULMONARY & CRITICAL CARE MEDICINE VA HOSPITAL OKC / OUHSC I have no financial disclosures Definition COPD is a preventable and treatable disease

More information

Karen Meyerson, MSN, APRN, NP C, AE C

Karen Meyerson, MSN, APRN, NP C, AE C Webinar for Michigan Center for Clinical Systems Improvement (Mi-CCSI) June 2015 Karen Meyerson, MSN, APRN, NP C, AE C Patient Education The goal of all patient education is to help patients take the actions

More information

CHRONIC OBSTRUCTIVE PULMONARY DISEASE

CHRONIC OBSTRUCTIVE PULMONARY DISEASE CHRONIC OBSTRUCTIVE PULMONARY DISEASE DEFINITION Chronic obstructive pulmonary disease (COPD) is a common preventable and treatable disease characterized by airflow limitation that is usually progressive

More information

COPD, Asthma, Or Something In Between? Sharon R. Rosenberg Assistant Professor of Medicine Northwestern University December 4, 2013

COPD, Asthma, Or Something In Between? Sharon R. Rosenberg Assistant Professor of Medicine Northwestern University December 4, 2013 COPD, Asthma, Or Something In Between? Sharon R. Rosenberg Assistant Professor of Medicine Northwestern University December 4, 2013 None Disclosures Definitions Asthma Asthma is a chronic inflammatory

More information

DOWNLOAD OR READ : REVERSING CHRONIC OBSTRUCTIVE PULMONARY DISEASE COPD PDF EBOOK EPUB MOBI

DOWNLOAD OR READ : REVERSING CHRONIC OBSTRUCTIVE PULMONARY DISEASE COPD PDF EBOOK EPUB MOBI DOWNLOAD OR READ : REVERSING CHRONIC OBSTRUCTIVE PULMONARY DISEASE COPD PDF EBOOK EPUB MOBI Page 1 Page 2 reversing chronic obstructive pulmonary disease copd reversing chronic obstructive pulmonary pdf

More information

American Thoracic Society (ATS) Perspective

American Thoracic Society (ATS) Perspective National Surveillance System for Chronic Lung Disease (CLD): American Thoracic Society (ATS) Perspective Gerard J. Criner, M.D. Chronic Obstructive Pulmonary Disease (COPD) l Definition: Group of chronic

More information

A Place For Airway Clearance Therapy In Today s Healthcare Environment

A Place For Airway Clearance Therapy In Today s Healthcare Environment A Place For Airway Clearance Therapy In Today s Healthcare Environment Michigan Society for Respiratory Care 2015 Fall Conference K. James Ehlen, MD October 6, 2015 Objectives Describe patients who will

More information

COPD. Dr.O.Paknejad Pulmonologist Shariati Hospital TUMS

COPD. Dr.O.Paknejad Pulmonologist Shariati Hospital TUMS IN THE NAME OF GOD COPD Dr.O.Paknejad Pulmonologist Shariati Hospital TUMS Definition of COPD* COPD is a preventable and treatable chronic lung disease characterized by airflow limitation that is not fully

More information

The role of lung function testing in the assessment of and treatment of: AIRWAYS DISEASE

The role of lung function testing in the assessment of and treatment of: AIRWAYS DISEASE The role of lung function testing in the assessment of and treatment of: AIRWAYS DISEASE RHYS JEFFERIES ARTP education Learning Objectives Examine the clinical features of airways disease to distinguish

More information

Provider Respiratory Inservice

Provider Respiratory Inservice Provider Respiratory Inservice 2 Welcome Opening Remarks We will cover: Definition of Asthma & COPD Evidence based guidelines for diagnosis, evaluation, and management of asthma Evidence based guidelines

More information

COPD in Korea. Division of Pulmonary, Allergy and Critical Care Medicine of Hallym University Medical Center Park Yong Bum

COPD in Korea. Division of Pulmonary, Allergy and Critical Care Medicine of Hallym University Medical Center Park Yong Bum COPD in Korea Division of Pulmonary, Allergy and Critical Care Medicine of Hallym University Medical Center Park Yong Bum Mortality Rate 1970-2002, USA JAMA,2005 Global Burden of Disease: COPD WHO & World

More information

Patient reported outcomes in respiratory diseases; How to assess clinical success in COPD

Patient reported outcomes in respiratory diseases; How to assess clinical success in COPD Patient reported outcomes in respiratory diseases; How to assess clinical success in COPD Thys van der Molen, University of Groningen, Department of General Practice, The Netherlands Mr Valette Smoking

More information

CARE OF THE ADULT COPD PATIENT

CARE OF THE ADULT COPD PATIENT CARE OF THE ADULT COPD PATIENT Target Audience: The target audience for this clinical guideline is all MultiCare providers and staff including those associated with our Clinically Integrated Network. The

More information

Chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease 0 Chronic obstructive pulmonary disease Implementing NICE guidance June 2010 NICE clinical guideline 101 What this presentation covers Background Scope Key priorities for implementation Discussion Find

More information

รศ. นพ. ว ชรา บ ญสว สด M.D., Ph.D. ภาคว ชาอาย รศาสตร คณะแพทยศาสตร มหาว ทยาล ยขอนแก น

รศ. นพ. ว ชรา บ ญสว สด M.D., Ph.D. ภาคว ชาอาย รศาสตร คณะแพทยศาสตร มหาว ทยาล ยขอนแก น รศ. นพ. ว ชรา บ ญสว สด M.D., Ph.D. ภาคว ชาอาย รศาสตร คณะแพทยศาสตร มหาว ทยาล ยขอนแก น COPD Guideline Changing concept in COPD management Evidences that we can offer COPD patients better life COPD Guidelines

More information

COPD UPDATE ıdr Shitrit David ıhead of the Pulmonary Department ımeir Medical Center

COPD UPDATE ıdr Shitrit David ıhead of the Pulmonary Department ımeir Medical Center COPD UPDATE 2012 ıdr Shitrit David ıhead of the Pulmonary Department ımeir Medical Center Definition of COPD COPD is a preventable and treatable disease with some significant extra pulmonary effects that

More information

COPD: Applying New Guidelines to Optimizing Evaluation and Treatment

COPD: Applying New Guidelines to Optimizing Evaluation and Treatment Transcript Details This is a transcript of a continuing medical education (CME) activity accessible on the ReachMD network. Additional media formats for the activity and full activity details (including

More information

Cigarette Smoking and Lung Obstruction Among Adults Aged 40 79: United States,

Cigarette Smoking and Lung Obstruction Among Adults Aged 40 79: United States, NCHS Data Brief No. 8 January 25 Cigarette Smoking and Lung Obstruction Among Adults Aged 4 79: United States, 27 22 Ryne Paulose-Ram, Ph.D., M.A.; Timothy Tilert, B.S.; Charles F. Dillon, M.D., Ph.D.;

More information

Referring for specialist respiratory input. Dr Melissa Heightman Consultant respiratory physician, UCLH,WH, CNWL

Referring for specialist respiratory input. Dr Melissa Heightman Consultant respiratory physician, UCLH,WH, CNWL Referring for specialist respiratory input Dr Melissa Heightman Consultant respiratory physician, UCLH,WH, CNWL Respiratory Specialist- who? GPSI Community Team Secondary Care Respiratory physician and

More information

Chronic obstructive pulmonary disease in over 16s: diagnosis and management

Chronic obstructive pulmonary disease in over 16s: diagnosis and management National Institute for Health and Care Excellence Final Chronic obstructive pulmonary disease in over 16s: diagnosis and management [D] Diagnosing COPD and predicting outcomes NICE guideline NG115 Evidence

More information

CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) MOUSTAPHA ABIDALI, DO CRITICAL CARE FELLOW UNIVERSITY OF ARIZONA- PHOENIX

CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) MOUSTAPHA ABIDALI, DO CRITICAL CARE FELLOW UNIVERSITY OF ARIZONA- PHOENIX CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) MOUSTAPHA ABIDALI, DO CRITICAL CARE FELLOW UNIVERSITY OF ARIZONA- PHOENIX COPD OUTLINE Definition and Overview Pathophysiology Diagnosis and Assessment Therapeutic

More information

Update on COPD John Hurst PhD FRCP

Update on COPD John Hurst PhD FRCP Update on COPD John Hurst PhD FRCP Reader / Consultant in Respiratory Medicine UCL / Royal Free London NHS Foundation Trust Director, UCL Royal Free COPD Centre j.hurst@ucl.ac.uk Questions 1. What is the

More information

Chronic Obstructive Pulmonary Disease (COPD) Clinical Guideline

Chronic Obstructive Pulmonary Disease (COPD) Clinical Guideline Chronic Obstructive Pulmonary Disease (COPD) Clinical These clinical guidelines are designed to assist clinicians by providing an analytical framework for the evaluation and treatment of patients. They

More information

The Art and Science of Pulmonary Rehab. Pam Haines, RCP Cardiopulmonary Rehab Manager

The Art and Science of Pulmonary Rehab. Pam Haines, RCP Cardiopulmonary Rehab Manager The Art and Science of Pulmonary Rehab Pam Haines, RCP Cardiopulmonary Rehab Manager ATS/ERS Statement on PR As defined by the 2013 ATS/ERS Statement on Pulmonary Rehabilitation, PR is a comprehensive

More information

SPIROMETRY TECHNIQUE. Jim Reid New Zealand

SPIROMETRY TECHNIQUE. Jim Reid New Zealand Jim Reid New Zealand The Basics Jim Reid Spirometry measures airflow and lung volumes, and is the preferred lung function test in COPD. By measuring reversibility of obstruction, it is also diagnostic

More information

COPD as a comorbidity of heart failure in elderly patients

COPD as a comorbidity of heart failure in elderly patients COPD as a comorbidity of heart failure in elderly patients Professor Mitja Lainscak, MD, PhD, FESC, FHFA Departments of Cardiology and Research&Education, General Hospital Celje Faculty of Medicine, University

More information

Looking Toward State Health Assessment.

Looking Toward State Health Assessment. CONNECTICUT DEPARTMENT OF PUBLIC HEALTH Policy, Planning and Analysis. Looking Toward 2000 - State Health Assessment. Table of Contents Glossary Maps Appendices Publications Public Health Code PP&A Main

More information

Life-long asthma and its relationship to COPD. Stephen T Holgate School of Medicine University of Southampton

Life-long asthma and its relationship to COPD. Stephen T Holgate School of Medicine University of Southampton Life-long asthma and its relationship to COPD Stephen T Holgate School of Medicine University of Southampton Definitions COPD is a preventable and treatable disease with some significant extrapulmonary

More information

COPD: A EUROPEAN PROBLEM WITH EUROPEAN SOLUTIONS

COPD: A EUROPEAN PROBLEM WITH EUROPEAN SOLUTIONS COPD: A EUROPEAN PROBLEM WITH EUROPEAN SOLUTIONS THE ERS actions to fight COPD Professor Nikos M. Siafakas MD, PhD Medical School, University of Crete President of the European Respiratory Society Dedicated

More information

International Journal of Medical and Health Sciences

International Journal of Medical and Health Sciences International Journal of Medical and Health Sciences Journal Home Page: http://www.ijmhs.net ISSN:2277-4505 Original article Level of C-Reactive Protein in Stable Chronic Obstructive Pulmonary Disease

More information

Chronic respiratory disease: towards better treatments

Chronic respiratory disease: towards better treatments Chronic respiratory disease: towards better treatments Alaina J. Ammit PhD Alaina.Ammit@uts.edu.au Professor of Respiratory Pharmacology, UTS Director, Woolcock Emphysema Centre, Woolcock Institute of

More information

Respiratory Therapists as COPD Educators

Respiratory Therapists as COPD Educators Respiratory Therapists as COPD Educators Becky Skinner, RRT-ACCS, CHT, MBA 38 th Annual Respiratory Care Seminar October 2018 1 Disclosure Statement I have no financial relationship with any manufacturer

More information

Commissioning for Better Outcomes in COPD

Commissioning for Better Outcomes in COPD Commissioning for Better Outcomes in COPD Dr Matt Kearney Primary Care & Public Health Advisor Respiratory Programme, Department of Health General Practitioner, Runcorn November 2011 What are the Commissioning

More information

COPD is a syndrome of chronic limitation in expiratory airflow encompassing emphysema or chronic bronchitis.

COPD is a syndrome of chronic limitation in expiratory airflow encompassing emphysema or chronic bronchitis. 1 Definition of COPD: COPD is a syndrome of chronic limitation in expiratory airflow encompassing emphysema or chronic bronchitis. Airflow obstruction may be accompanied by airway hyper-responsiveness

More information

Outline FEF Reduced FEF25-75 in asthma. What does it mean and what are the clinical implications?

Outline FEF Reduced FEF25-75 in asthma. What does it mean and what are the clinical implications? Reduced FEF25-75 in asthma. What does it mean and what are the clinical implications? Fernando Holguin MD MPH Director, Asthma Clinical & Research Program Center for lungs and Breathing University of Colorado

More information

Advances in the management of chronic obstructive lung diseases (COPD) David CL Lam Department of Medicine University of Hong Kong October, 2015

Advances in the management of chronic obstructive lung diseases (COPD) David CL Lam Department of Medicine University of Hong Kong October, 2015 Advances in the management of chronic obstructive lung diseases (COPD) David CL Lam Department of Medicine University of Hong Kong October, 2015 Chronic obstructive pulmonary disease (COPD) COPD in Hong

More information

JOINT CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) MANAGEMENT GUIDELINES

JOINT CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) MANAGEMENT GUIDELINES JOINT CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) MANAGEMENT GUIDELINES Authors Dr Ian Benton Respiratory Consultant COCH Penny Rideal Respiratory Nurse COCH Kirti Burgul Respiratory Pharmacist COCH Pam

More information

COPD GOLD Guidelines & Barnet inhaler choices. Dr Dean Creer, Respiratory Consultant, Royal Free London NHS Foundation Trust

COPD GOLD Guidelines & Barnet inhaler choices. Dr Dean Creer, Respiratory Consultant, Royal Free London NHS Foundation Trust COPD GOLD Guidelines & Barnet inhaler choices Dr Dean Creer, Respiratory Consultant, Royal Free London NHS Foundation Trust GOLD 2017 Report: Chapters 1. Definition and Overview 2. Diagnosis and Initial

More information

Differential diagnosis

Differential diagnosis Differential diagnosis The onset of COPD is insidious. Pathological changes may begin years before symptoms appear. The major differential diagnosis is asthma, and in some cases, a clear distinction between

More information

Asthma ASTHMA. Current Strategies for Asthma and COPD

Asthma ASTHMA. Current Strategies for Asthma and COPD Current Strategies for Asthma and COPD Talmadge E. King, Jr., M.D. Krevins Distinguished Professor of Medicine Chair, Department of Medicine University of California San Francisco (UCSF) San Francisco,

More information

COPD: Preventable and Treatable. Lecture Outline. Diagnosis of COPD. COPD: Defining Terms

COPD: Preventable and Treatable. Lecture Outline. Diagnosis of COPD. COPD: Defining Terms COPD: Preventable and Treatable Christopher H. Fanta, M.D. Partners Asthma Center Pulmonary and Critical Care Division Brigham and Women s Hospital Harvard Medical School Lecture Outline I. Diagnosis and

More information

Global Strategy for the Diagnosis, Management and Prevention of COPD 2016 Clinical Practice Guideline. MedStar Health

Global Strategy for the Diagnosis, Management and Prevention of COPD 2016 Clinical Practice Guideline. MedStar Health Global Strategy for the Diagnosis, Management and Prevention of COPD 2016 Clinical Practice Guideline MedStar Health These guidelines are provided to assist physicians and other clinicians in making decisions

More information

Study No.: Title: Rationale: Phase: Study Period: Study Design: Centres: Indication: Treatment: Objectives: Primary Outcome/Efficacy Variable:

Study No.: Title: Rationale: Phase: Study Period: Study Design: Centres: Indication: Treatment: Objectives: Primary Outcome/Efficacy Variable: The study listed may include approved and non-approved uses, formulations or treatment regimens. The results reported in any single study may not reflect the overall results obtained on studies of a product.

More information

exacerbation has greater impact on functional status than frequency of exacerbation episodes.

exacerbation has greater impact on functional status than frequency of exacerbation episodes. Original Article Singapore Med J 2011, 52(12) 894 Changes in the BODE index, exacerbation duration and hospitalisation in a cohort of COPD patients Bu X N, Yang T, Thompson M A, Hutchinson A F, Irving

More information

Douglas W. Mapel MD, MPH, Melissa Roberts PhD

Douglas W. Mapel MD, MPH, Melissa Roberts PhD Original Article Spirometry, the St. George s Respiratory Questionnaire, and other clinical measures as predictors of medical costs and COPD exacerbation events in a prospective cohort Douglas W. Mapel

More information

They are updated regularly as new NICE guidance is published. To view the latest version of this NICE Pathway see:

They are updated regularly as new NICE guidance is published. To view the latest version of this NICE Pathway see: bring together everything NICE says on a topic in an interactive flowchart. are interactive and designed to be used online. They are updated regularly as new NICE guidance is published. To view the latest

More information

Respiratory Disease. Dr Amal Damrah consultant Neonatologist and Paediatrician

Respiratory Disease. Dr Amal Damrah consultant Neonatologist and Paediatrician Respiratory Disease Dr Amal Damrah consultant Neonatologist and Paediatrician Signs and Symptoms of Respiratory Diseases Cardinal Symptoms Cough Sputum Hemoptysis Dyspnea Wheezes Chest pain Signs and Symptoms

More information

Guideline for the Diagnosis and Management of COPD

Guideline for the Diagnosis and Management of COPD Guideline for the Diagnosis and Management of COPD Introduction Chronic obstructive pulmonary disease (COPD) is a respiratory disorder largely caused by smoking. It is characterized by progressive, partially

More information

Fighting for Air, In Emphysema

Fighting for Air, In Emphysema Fighting for Air, The Mechanism of Shortness of Breath In Emphysema Albert A. Rizzo, MD FCCP FACP Speaker, Nationwide Assembly of the American Lung Association & Section Chief Pulmonary/Critical Care Medicine

More information

Lecture Notes. Chapter 4: Chronic Obstructive Pulmonary Disease (COPD)

Lecture Notes. Chapter 4: Chronic Obstructive Pulmonary Disease (COPD) Lecture Notes Chapter 4: Chronic Obstructive Pulmonary Disease (COPD) Objectives Define COPD Estimate incidence of COPD in the US Define factors associated with onset of COPD Describe the clinical features

More information

Understanding the Basics of Spirometry It s not just about yelling blow

Understanding the Basics of Spirometry It s not just about yelling blow Understanding the Basics of Spirometry It s not just about yelling blow Carl D. Mottram, RRT RPFT FAARC Technical Director - Pulmonary Function Labs and Rehabilitation Associate Professor of Medicine -

More information

COPD: Genomic Biomarker Status and Challenge Scoring

COPD: Genomic Biomarker Status and Challenge Scoring COPD: Genomic Biomarker Status and Challenge Scoring Julia Hoeng, PMI R&D Raquel Norel, IBM Research 3 rd October 2012 COPD: Genomic Biomarker Status Julia Hoeng, Ph.D. Philip Morris International, Research

More information

Roflumilast (Daxas) for chronic obstructive pulmonary disease

Roflumilast (Daxas) for chronic obstructive pulmonary disease Roflumilast (Daxas) for chronic obstructive pulmonary disease August 2009 This technology summary is based on information available at the time of research and a limited literature search. It is not intended

More information

Dr Rob Young. General Physician Auckland City Hospital

Dr Rob Young. General Physician Auckland City Hospital Dr Rob Young General Physician Auckland City Hospital Managing COPD case studies. Associate Professor Robert Young BMedSc, MBChB, DPhil (Oxon), FRACP, FRCP Department of Medicine, Auckland City Hospital

More information

COPD and Asthma Update. April 29 th, 2017 Rachel M Taliercio, DO Staff, Respiratory Institute

COPD and Asthma Update. April 29 th, 2017 Rachel M Taliercio, DO Staff, Respiratory Institute COPD and Asthma Update April 29 th, 2017 Rachel M Taliercio, DO Staff, Respiratory Institute What we ll be talking about COPD: diagnosis, management of stable COPD, COPD exacerbations Asthma: diagnosis,

More information