Download COPD Unmet Needs Assessment

COPD Unmet Needs
Assessment
John Walsh, USA
COPD is a global burden
• Over 340 mn people suffer from COPD
worldwide
• COPD is 5th leading cause of death
• COPD is increasing in prevalence
• COPD is under-diagnosed and under-treated
The ICC campaign
Why Global COPD Unmet Needs Assessment?
• To get a better understanding of the COPD
situation in different countries/regions
• To better understand the gaps
• To provide solutions
Data and opinions were sought
• From ICC members representing 29 different
countries
• During an ICC workshop, held in Munich at ERS
on Sept. 22, 2006
• To get information about
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–
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Smoking habits
Awareness among people and physicians
Diagnosis and treatment
Medication available and affordable for patients
Unmet needs
29 countries were surveyed
Huge parts of the world represented
• Current world population: 6555 mn
• 2842,6 mn people represented
• 43,4% of world population
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–
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43 % of Asia/Pacific
60 % of Europe
72 % of America
5 % of Africa
• Most of the unmet needs
will be captured!
U
S
Country
O
R
SA
M
A
L
IT
A
KG
Z
TH
A
AU
S
C
AN
SW
E
SI
N
R
N
R
K
PO
U
PH
I
AU
T
SU
I
PO
L
C
ZE
BR
A
KO
R
N
ED
JP
N
M
E
X
SY
R
U
SA
EO
C
H
N
AR
G
G
ER
G
R
% of smokers
60,0
Percent of Smokers
50,0
40,0
30,0
20,0
10,0
0,0
In Asia, most men smoke
1) CHN 70,2 %
2) RUS 63,0 %
3) GEO 57,5 %
4) SYR 46,0 %
5) JPN 43,3 %
6) KGZ 41,4 %
In Europe, most women smoke
1) BRA 30,0 %
2) RUS 30,0 %
3) NED 28,0 %
4) CZE 28,0 %
5) GER 28,0 %
6) AUT 26,0 %
One out of three are smokers
• In the surveyed countries (pop. 2842,6 mn),
926,3 mn people smoke: 32,6 %
• Smoking is increasing, especially in women
• Only decreasing in countries, where huge
anti-smoking campaigns (TV, journals, ban in
public places) have been launched:
– USA, Canada, Italy, Norway
Warning labels on cigarette packs
Are available in all surveyed countries!
But:
No COPD warning in most countries!
Except: NOR, CZE, USA, CAN, JPN, THA, AUS, RSA
Smoking can damage health
• Is known throughout all countries
• But smoke of indoor heating and cooking
with biomass fuels is not recognized to be
harmful!
Country
KOR
SIN
ARG
MEX
RUS
RSA
GEO
KGZ
BRA
POR
MAL
PHI
SYR
THA
CHN
JPN
USA
UK
CZE
SUI
POL
CAN
GER
AUT
AUS
90,0
SWE
NED
NOR
ITA
Awareness in %
100,0
Awareness of COPD is low in public
80,0
70,0
60,0
50,0
40,0
30,0
20,0
10,0
0,0
Patients don’t seek help
• Smokers showing symptoms of COPD like
– Coughing,
– Sputum production
– Shortness of breath
• Smokers do not relate these signs to
smoking or COPD
• And do not seek medical treatment
GPs generally do not diagnose or
treat COPD
• The awareness of COPD among GPs is
quite high
• The opinion of the interviewed ICC
members revealed that only few GPs
would diagnose COPD
• As a consequence, GPs do normally not
treat COPD
• Only in Austria, Italy, The Netherlands and
Canada, more than 80 % of GPs will
diagnose and treat COPD
K
Country
SA
PH
I
M
A
L
C
ZE
BR
A
TH
A
C
H
N
KG
Z
G
EO
SY
R
SA
R
U
S
R
U
IT
A
M
E
X
PO
R
N
O
R
SW
E
SI
N
AR
G
U
SU
I
PO
L
G
ER
C
AN
JP
N
N
ED
R
AU
T
AU
S
KO
% of GPs with spirometer
90
Most GPs do not have access to spirometry
80
70
60
50
40
30
20
10
0
Medical treatment is available in all
surveyed countries
Short acting 2-agonists
Long acting 2-agonists
Short acting anticholinergics+
Long acting anticholinergics+
Sustained-release Theophylline
Inhaled corticosteroids
Fixed combinations of long acting 2-agonists
and corticosteroids*
• Systemic corticosteroids
•
•
•
•
•
•
•
+
In Syria not available
*
In Japan and Kyrgyzstan not available
Not in all countries treatment costs will
be covered by health insurances
• In most of the developed countries, health
insurances will cover treatment costs
• No full coverage in Mexico, Argentina,
Brazil, Russia, Canada, USA, Kyrgyzstan,
Philippines, Malaysia, Georgia, China,
Syria and Portugal
• Large population can’t afford treatment
Huge information about COPD is
available
• In nearly all surveyed countries COPD
patient organizations exist
• Guidelines for diagnosis and treatment
exist
• The GOLD guidelines are mainly known
by specialists
• Many GPs don’t know the GOLD
guidelines or don’t follow them
Biggest Unmet Needs
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
Awareness among patients about disease and risk factors (e.g. smoking)
Lack of smoking cessation programs
More anti-smoking campaigns are needed (TV etc.)
Need for a better approach to prevention and treatment of cigarette smoking
Lack of early diagnosis
Huge number of undiagnosed/untreated COPD patients
Diagnosis among GPs (spirometry needed)
Differentiation between asthma and COPD unclear to many GPs
Treatment algorithms are not followed/known by GPs
No proper disease management by GPs
Lack of rehabilitation facilities
Funding of all drugs needed for treatment
Lack of lung specialists
More access to oxygen therapy
Governmental programs to fight COPD
Conclusions - Public
• Percentage of smokers is too high
• More effective anti-smoking campaigns
are needed
• Raise public awareness of COPD
• Drive patients with symptoms to GPs
• Enable smoking cessation programs
Conclusions - Physicians
• Increase knowledge regarding diagnosis,
treatment and management of COPD
among GPs
• Follow GOLD guidelines
• Spirometry is needed
• More rehabilitation centres needed
• More specialists needed
Conclusions - Government
• Increase coverage for medical treatment
• Make medications available for poor
patients
• Smoking bans in public areas needed
• COPD labeling on cigarette packs needed