A recent study, published in the Annals of the American Thoracic Society, revealed that chronic obstructive pulmonary disease (COPD) symptoms worsen when individuals are exposed to high indoor temperatures and air pollutants.
In the study, “Respiratory Effects of Indoor Heat and the Interaction with Air Pollution in COPD,” conducted by Meredith C. McCormack, MD, MHS, along with her John Hopkins University colleagues, 69 participants with moderate to severe COPD were analyzed throughout the hottest recorded days of the year.
A daily questionnaire was provided to participants that included the Breathlessness, Cough, and Sputum Scale (BCSS), “which provides a standardized rating of respiratory symptoms.” Lung function was analyzed through daily spirometry. Participants also documented their use of rescue inhalers.
Based on the questionnaire results, researchers discovered that “participants spent the overwhelming majority of their time indoors and that BCSS scores worsened with rising indoor temperatures and the use of rescue inhalers also increased. Additionally, the “effects of higher indoor temperatures were experienced immediately and continued for one to two days and although 86 percent of participants lived in a home with some form of air conditioning, they did not turn it on during 37 percent of study days.”
McCormack believes that rising temperatures attributed to global warming will provide healthcare professionals with “an opportunity for targeted interventions and policy makers with the need to develop mitigation strategies to protect those most vulnerable to heat.”
"Given that participants spent an overwhelming majority of their time indoors, which we believe is representative of patients with COPD generally, optimizing indoor climate and reducing indoor pollution represents a potential avenue for improving health outcomes," said McCormack.
A recent study published in the Annals of Thoracic Society, found that older adults with chronic obstructive pulmonary disease (COPD) showed a lack of adherence of medications after being diagnosed with depression.
Coauthor of the study, Linda Simoni-Wastila, said, “with a prevalence of 17 to 44 percent, depression remains one of the most common, yet least recognized and under-treated, co-morbidities among patients with COPD."
Between 2006 and 2012, a random sample of Medicare claims were analyzed with a focus on a, “relationship between a new episode of depression and COPD medication adherence.” The beneficiaries that were examined had, “filled their COPD prescriptions at least twice in the 24 months after diagnosis in their analysis.” The study was then narrowed down to the 20% of those beneficiaries who had been diagnosed with depression, “within 24 months after a COPD diagnosis.”
The study also found that the, “average monthly adherence to medications for COPD was low among all of the patients, peaking at 57% 1 month after the first prescription and dropping to 35% within 6 months. Only 20% of patients with depression and COPD fell into the highest adherence category during the 24-month follow-up period compared with 22% of patients with COPD who did not have depression.”
Further investigations found that patients who were diagnosed with over three conditions had, “the highest risk for poor adherence.” This insinuates that, “patients may prioritize filling certain medications or may struggle to maintain complex regimens.”
The researchers hope that the study will raise awareness about the correlation between reduced medication adherence and patients with multiple medical conditions.
The American Academy of Family Physicians (AAFP) is now providing updated resources, including a booklet and brochure, focusing on the differences and similarities between asthma and chronic obstructive pulmonary disease (COPD).
The booklet, "COPD and Asthma: Differential Diagnosis," was released for physicians, which contained information on the, “diagnostic differences between COPD and asthma, how to help patients self-manage their illness, and the importance of short- and long-term monitoring. It also provides guidance on how to maximize lung function and manage exacerbations and airflow limitations.”
The booklet highlights some of the more prominent differences in between COPD and asthma including:
- Asthma on-set occurance before the age of 20, while COPD on-set occurs after 40,
- Asthma symptoms generally vary over time, while COPD symptoms often persist with treatment,
- Asthma symptoms improve with bronchodilator treatment, while COPD symptoms may not respond to bronchodilator treatment.
The patient education handout, "COPD and Asthma: What You Need to Know", includes the definition of COPD and asthma. The handout also contains information about common symptoms and treatment options.
Both the booklet and brochure were sent to, “AAFP members and internal medicine physicians who subspecialize in pulmonology in the 14 states that have the highest prevalence of COPD.”
Clare Hawkins, a physician who helped develop the materials, explained, “The number of people who get ill and (are) hospitalized makes this a big public health priority, especially in disadvantaged populations.”
Both COPD and asthma are greatly impacting the health of Americans and may be underdiagnosed. Both conditions also appear alike, due to the symptoms.
“COPD is the third leading cause of death in the United States, according to the American Lung Association. An estimated 12.7 million Americans have been diagnosed with COPD, and 24 million U.S. adults have evidence of impaired lung function.”
Asthma is also a growing condition in the U.S., with 22.5 million Americans diagnosed. “The condition is responsible for nearly 440,000 hospitalizations, 1.8 million emergency department visits and 14.2 million physician office visits.”
The AAFP’s physician resources should aid physicians in selecting the best treatments for patients on an individual basis and focus on smoking cessation.
A recent study finds that music therapy benefits chronic obstructive pulmonary disease (COPD) patients. The disease, “affects a person’s lungs and breathing, and the study found that music therapy in conjunction with traditional therapies can help improve symptoms better than standard treatment alone.” COPD symptoms include tightness of the chest, shortness of breath, and an ongoing cough.
Sixty-eight individuals, “who were diagnosed with chronic disabling respiratory diseases, including COPD,” participated. The study was conducted over a six-week period while, “a randomized group underwent musical therapy involving live music, visualizations, wind instrument playing and singing, which incorporated breath control techniques.”
“Music therapy has emerged as an essential component to an integrated approach in the management of chronic respiratory disease. The results of this study provide a comprehensive foundation for the establishment of music therapy intervention as part of pulmonary rehabilitation care,” explained Dr. Jonathan Raskin.
COPD patients have treatment goals, which strive to, “relieve symptoms, slow progression of the disease, improve exercise tolerance, prevent and treat complications, and improve overall health. These goals can be met with medical intervention and treatment coupled with alternative methods.”
Alternative remedies for COPD include:
- Control your breathing: Speak with your doctor or breathing specialist to find ways to better control your breathing
- Clear your airways: Keep your airways clear of mucus by drinking water, using a humidifier, and controlling your coughs
- Exercise regularly: Regular exercise improves overall strength and respiratory muscles.
- Eat healthy foods: A healthy diet keeps your weight in check and maintains overall strength
- Avoid smoke and air pollution
- See your doctor regularly
One of the most effective ways to prevent COPD is to completely stop smoking, as COPD is strongly linked to smoking.
Findings from a recently released study from COPD: Journal of Chronic Obstructive Pulmonary Disease, illustrated that “levels of anxiety are up to three times higher in older adults with chronic obstructive pulmonary disease (COPD) than in patients without COPD.”
Why is this?
The study, conducted by researchers from the University of Toronto, sampled more than 11,000 adults (50 years of age or older), measuring for “sociodemographic factors, social support, health behaviors, sleep problems, pain, functional limitations and early childhood adversities.” Based on these factors, the research team determined that of the more than 700 adults that reported their COPD diagnosis, “one in 17 had anxiety within the past year, or about 5.8 percent.”
Lead study author, Professor Esme Fuller-Thomson, noted that “even after accounting for 18 possible risk factors for Generalized Anxiety Disorder (GAD), individuals with COPD still had 70 percent higher odds of GAD compared to those without COPD.”
So, what are the risk factors associated?
The study was able to determine that “lack of social support and exposure to parental domestic violence during the patients’ childhoods” was one of the leading factors. Additionally, “older adults without social support involved in their important decision making had more than seven times the odds of having anxiety in comparison with the patients who did have a friend or social support.” In participants who had been exposed to ten incidences or more of parental domestic violence, “their odds for anxiety in comparison to the adults without COPD rose to about five times the risk” of those patients without COPD.
The study’s aim was to highlight the need for healthcare provider’s participation in “identifying and providing promising interventions to reduce anxiety for individuals with COPD, in particular by screening for and addressing pain and functional limitations and targeting those most at risk.”
Lung diseases like chronic obstructive pulmonary disease (COPD) and emphysema can often lead to increased and worsened health problems if left untreated. The most powerful treatments often come in the form of exercise, education, breathing methods and taking medications as prescribed.
It has been noted in several studies that a combination of these techniques can help slow the progression of such diseases and improve quality of life. Additional benefits have also been seen when COPD patients quit smoking, lower their blood pressure and properly manage their weight, as all these factors contribute to the progression of these diseases.
In effort to help patients some hospitals and medical centers have begun offering exercise classes like yoga as a form of therapy to increase stamina in the lungs. These programs are helping patients to lead more fulfilling lives by teaching them to adjust their daily activities.
In addition to these exercise programs, medical facilities are also supplyingpatients with information about their conditions and ways to cope. “Part of the education is about communication, communicating their needs and educating them so they know what to ask about,” said Bobbi Brown, LRH respiratory therapist, Lakeland Regional Health. Education is critical to proper treatment and symptom recognition is the condition worsens, so the disease can be managed accordingly.
These skills, combined with proper and regular medication and education, patients dealing with chronic lung conditions can improve daily life and increase physical endurance, helping them maintain a healthier, active lifestyle.
A recent review of chronic obstructive pulmonary disease (COPD) studies was conducted that found patients should be maximizing their time spent doing daily simple exercises in order to “reduce the risk of developing cardiovascular and metabolic disease, some cancers, and all-cause mortality.”
A total of three studies were reviewed, all included researchers from Australian universities, and focused on “lung disease, health behavior change, physical activity and sedentary behavior, and highlighted that performing 150 minutes of exercise weekly can reduce the risk of developing cardiovascular and metabolic disease, some cancers, and all-cause mortality.”
While 150 minutes of exercise is often unattainable for COPD patients, there is still “strong evidence” that even the smallest amount of exercise will help those suffering by improving energy levels and increasing exercise capacity which leads to a higher quality of life.
Also noted in the study review was the emphasis to reduce sedentary positions like sitting. By standing or moving, patients can improve blood flow, which reduces the risk for disease in the heart and blood vessels.
Dr. Kylie Hill, the review’s senior author advised a 30-minute walk each to help improve circulation and increase propensity to exercise. In doing so, patients can reduce their risk to have more invasive rehabilitation or surgery in the future.
According to a study presented at the European Respiratory Society’s International Congress this past September suggested that there may be a way to identify if an individual is suffering from chronic obstructive pulmonary disease (COPD) without hounding them with questions about their smoking habits. This tool may even have a way to “speed up the diagnosis time and reveal COPD before serious exacerbations and further loss of function occurs.”
The research team noted that they felt “COPD is under diagnosed, partly due to subpar screening tools that rely on smoking history and patient reported cough and sputum.” They sought to find a screening tool that would help more individuals get diagnosed faster, leading to quicker treatment.
The results of this were a set of five “yes or no” questions that had the ability to identify “whether a person had moderate or severe COPD, or if people were at risk for COPD exacerbations. The questions asked about breathing, how easily a person got tired, and acute respiratory illness.” It was found that the questions were able to not only identify people before they have serious complications of COPD, but also included an assessment of exacerbation risk, as noted by the researchers.
The team also noted that in the future, they hope the questionnaire can “improve how physicians find COPD”, and also pinpoint patients with “more severe disease and those at risk for exacerbations, so they can be treated.”
Most of us have heard of stem cells, but not as many know how helpful they can be for chronic conditions such as chronic obstructive pulmonary disease (COPD). Between the story below and the results of recent treatments using stem cell therapy, you can determine for yourself if this type of treatment is right for you or someone you know.
Our story begins with a woman namedMarilyn Calick. Marilyn had suffered from asthma for her entire life, but over the past decade she had also developed COPD, forcing her to use steroids and a rescue inhaler daily. This type of condition and treatment is all too familiar for many Americans.
While the medications helped manage her symptoms, they weren’t anything close to a permanent solution. If she were to stop taking the medication, her symptoms would come back, sometimes worse than before. Marilyn felt like she was running out of options. That’s when she reached out to Dr. David Borenstein, an integrative medicine physician in New York City.
Dr. Borenstein is just one of many physicians in the US using stem cells to treat certain diseases, including COPD. The stem cells, “which can self-renew and replace damaged areas of the body”, are drawn from the “patient’s buttocks or midsection during liposuction, and then separates the stem cells in a centrifuge. Next, stem cells are mixed in a solution, which is administered through an IV and put into a nebulizer, from which the patient inhales them.”
Dr. Borenstein says that about “two-thirds of his patients see COPD relief within several weeks to about five months, and that those results last for about a year.” These results sound much more promising than daily medication and a decreased quality of life. The procedure costs about $8,000, which is usually less than the more invasive lung reduction surgery that is more common.
After having the procedure even Marilyn can attest to an improved quality of life, saying she can now “go out with different friends, stand for long periods of time and walk places”.