By Michelle Anne P. Soliman
BREATHLESSNESS, chronic cough, and bringing up phlegm may not just be signs that one is getting older. People aged 40 and above who are exposed to biomass fuel, air pollution, and occupational dust, and cigarette smokers may be at risk of Chronic Obstructive Pulmonary Disease (COPD) — even non-smokers. In the early stages of the disease, the symptoms are silent.
According to the Mayo Clinic, COPD “is a chronic inflammatory lung disease that causes obstructed airflow from the lungs. Symptoms include breathing difficulty, cough, mucus (sputum) production and wheezing. It’s caused by long-term exposure to irritating gases or particulate matter, most often from cigarette smoke. People with COPD are at increased risk of developing heart disease, lung cancer and a variety of other conditions.”
COPD begins when damage to the lungs’ airways and air sacs persist due to inhalation of harmful gases. The damage is felt only after 20 to 50% of lung damage has persisted.
COPD affects 210 million people worldwide. It is projected that it will be the world’s leading cause of death by 2020.
Today it ranks as the seventh top cause of death in the Philippines. Based on a prevalence study conducted in 2005, the disease has a 14% prevalence rate in Metro Manila and a 20% prevalence rate in rural areas.
Patients with COPD may undergo pharmacological and non-pharmacological therapies to treat the condition. Pharmacological treatment involves the intake of drugs which dilate airways and prevent lung damage. Non-pharmacological treatment involves quitting smoking, and preventing exposure to noxious gases, flu and pneumonia vaccination, and pulmonary rehabilitation. Pulmonary rehabilitation allows patients to exercise, be educated and given advice about the disease.
The Philippine College of Chest Physicians (PCCP), in collaboration with Novartis Healthcare Philippines, Inc., launched the BREATHE Initiative on Oct. 18 at the Makati Diamond Residences Hotel during a media briefing on “The Many Faces of COPD.”
BREATHE stands for Broadening Reach, Enhancing Awareness, and Transforming Health Education. PCCP board member Dr. Jubert Benedicto explained: “We would like to broaden the reach as far as the target population is concerned. Not just the health care practitioners, but also including the media to help us with information dissemination… One of the key priorities of the PCCP Board is to craft them in a language understandable by the lay person.”
Dr. Benedicto said that the initiative is anchored on the utilization of technology (webcasts and social media), and physician and public education to spread awareness about COPD to the general population.
With this initiative, the PCCP aims to ensure reaching training institutions and chapters, while Novartis gives support through local and global educational grants, and providing equipment for diagnosis.
To make a diagnosis of COPD easier, Novartis developed the Air Smart Spirometer app, a COPD screening device which uses a smartphone.
The spirometer — a device that is used to measure the function of the lungs and the airways — is accompanied by the app which may be downloaded via Android or Google Play. The app requires one to enter demographic data (name, birthdate, ethnicity, gender, height, and weight). Then the spirometer turbine is attached to the phone. Using the turbine’s mouthpiece, the patient takes a deep breath, then exhales thoroughly through the mouthpiece for at least six seconds. The value on-screen will validate whether the patient is at risk of COPD.
The Air Smart Spirometer is aimed to be utilized as a mass screening test.
Due to a lack of data on COPD in the Philippines, the PCCP is conducting the C-Pass Study (COPD Profile and Survival Study), a landmark study which will investigate COPD in the Philippines.
“It is a five-year study nationwide. We’re going to look more in-depth into not just prevalence, but also other factors so we can understand what COPD looks like in the country. Part of that project is the employment of pulmonary function test across the different regions. It is the largest study of its kind in the country,” said PCCP President Dr. Charles Yu.
The study will compare the profiles of Filipino COPD patients with international profiles. “What we’re taking a look at is, ‘What is the profile of a COPD patient?,’ Is it the same as that of a foreign COPD patient? So, it has local flavor. And we’re looking at the survival of [our] COPD patient. So that we have an idea of how good we are in treating patients,” said Dr. Tim Trinidad, chairman of the Council on COPD and Pulmonary Rehabilitation.
“It is a national study. It is going to involve [PCCP’s] nine chapters and 24 training institutions… We started last year (2016). Hopefully, we’ll be ending [by] 2020,” Dr. Trinidad added.
COPD Awareness Day is celebrated on Nov. 15 to spread awareness about the disease.
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