Poor Care Received by COPD Patients

Patients with COPD have less access to care, higher treatment costs, and lower standards of care.

According to a recent study, patients with chronic obstructive pulmonary disease (COPD) face numerous challenges accessing care, with treatment costs hospitals that do not provide the recommended standard of care.

The study, published in The Lancet Respiratory Medicine, included information gathered from interviews with patient representatives, caregivers, healthcare providers, insurance and pharmaceutical companies to identify the challenges faced by COPD patients and provide potential solutions.

"This report reveals a real patchwork of care for patients with chronic obstructive pulmonary disease. The disease is the third leading cause of death in the USA, and disproportionately affects some of society's most vulnerable people, yet many patients lack access to basic therapies to improve their quality of life," said lead author Dr MeiLan K Han, MD, MS. "As a physician, I can discuss best treatments with my patients, only to later find out it isn't covered by their insurance, or the co-pay is simply too high. This report aims to move us from debating what ideal care could look like, back to a discussion of what patients are actually facing on a day to day basis."

COPD is a broad term used to describe different progressive lung diseases, such as emphysema and chronic bronchitis. Patients with COPD typically experience increasing breathlessness and are treated with inhalers and pulmonary rehabilitation.

According to the study, approximately 15 million adults have been diagnosed with COPD, but some studies suggest up to 28.9 million people display evidence of pulmonary obstruction, which would mean half of the population remains undiagnosed. Patients with COPD are typically older adults and from lower socio-economic backgrounds.

The researchers found that some patients face co-payments of $75 or more per drug, which could result in patients skipping days, not taking full dosages, or not collecting refills. In fact, researchers found that only half of patients took their dosages as prescribed. They believe the high cost of COPD drugs is partly due to the fact there are no generic inhalers in the United States.

Patients in the study describe pulmonary rehabilitation as the most helpful in improving their quality of life. However, access to rehabilitation is limited due to various insurance coverage and a shortage of programs in certain geographic locations.

Each year, there are more than 10 million physician visits, 1.5 million emergency department visits, and 700,000 hospital stays due to COPD, and 1 in 5 hospital admissions are readmitted within 1 month, according to the study.

Poor hospital care is also discussed since researchers found that only 1 in 3 hospital admissions offered patients the standard recommended treatments. A lack of written protocols for inpatients also led to COPD’s low priority within a hospital, the researchers reported.

Researchers found that most readmissions for COPD is due to lack of access to care or support outside of the hospital setting. Improving diagnosis and access to treatment would be an area for improvement, according to the study. In addition, better education for patients and physicians could also improve treatment.

Researchers also believe that better coordination between insurers, pharmaceutical companies, and physicians could reduce financial burdens, which has the potential to increase medication adherence and reduce overall healthcare spending.

More research is needed to understand the disease more fully and develop new treatments, the researchers concluded.