Optimizing Therapies Help People with COPD Breathe Longer and Better

Living well with COPD requires knowledge and understanding to best manage the condition. However, many Canadians have COPD without knowing it. Therefore, testing is essential for proper diagnosis.

Chronic obstructive pulmonary disease (COPD) refers to a group of lung diseases where people have difficulty breathing due to narrowed airways. It includes chronic bronchitis and emphysema. It’s estimated that 1.6 million Canadians live with COPD and that almost as many people have the disease without
knowing it.¹

Understanding major symptoms

A classic symptom of COPD is shortness of breath — also known as dyspnea — which makes it hard to perform everyday activities, such as going up and down stairs, carrying groceries, or making the bed. About 75 per cent of people living with COPD experience some degree of shortness of breath. Dyspnea is linked to a downward health spiral, where people living with COPD stop doing everyday activities because it’s difficult to breathe — forcing them to reprioritize regular activity. This means less movement and exercise, which in turn may lead to weakening of muscles and joints. As a result, other health issues, like weight gain, heart problems, as well as emotional and mental health problems including anxiety and depression may affect people living with COPD. All these added health challenges are very difficult to manage. This health situation was made worse by the COVID-19 pandemic when people were required to stay at home with limited daily physical activity and reduced visits with family and friends.

Other COPD symptoms can include:

• Prolonged cough lasting more than three months
• Cough with mucus
• Lung infections from colds and flu that may last longer than usual
• Wheezing
• Weight loss without trying

Living with COPD can be challenging

While the burden of living with COPD is challenging, it can also be stressful on the families and caregivers who are looking to help. Day-to-day activities, such as household chores, may fall to the primary caregiver when the person with COPD has limitations. This can take a toll on the individual who may struggle with feelings of being overwhelmed and burned out, creating undue stress and tension in the household. There can also be economic burdens if the person living with COPD is unable to work or contribute financially to the running of the household.

While cigarette smoking is a common risk factor causing 80 to 90 per cent of COPD cases, other types of tobacco, such as pipe and cigar, as well as second-hand smoke, shisha, and cannabis, are also included.² There are other less common causes of COPD, like severe childhood lung conditions, genetics, and exposure to biomass smoke.

One serious COPD complication is an exacerbation — also known as a COPD flare-up or lung attack. These flare-ups occur when COPD symptoms continue to worsen over a short period of time. Since these lung flares can be life-threatening events, and with 1 out of 4 people having weaker lungs as a result, the aim should be prevention overall. Until that’s possible, however, when a lung attack happens, it must be treated immediately. According to the Canadian Institute for Health Information (CIHI) inpatient information for 2019–2020, COPD or bronchitis was the second most common reason for hospital admissions following childbirth.

With close to 1.6 million Canadians believed to be unaware they may have COPD, patients experiencing shortness of breath, cough, and phlegm should consult with their health-care provider.

Options available to improve care, quality of life, and longevity

COPD management is centred around two goals — symptom management and exacerbation/flare-up management.

Symptom management is based on the patient’s specific needs, depending on the disease severity — mild, moderate, or severe. The standard protocol for people with moderate to severe COPD over the past two decades has incorporated inhaled combinations of therapy including a variety of long-acting options and corticosteroid inhalers. While the combinations of therapies are still very much part of COPD treatment, there are now other options that are longer-lasting, safer, and more effective — giving people the ability to breathe better for longer. The devices containing these medications have also become easier to use and can dispense multiple medications in a single inhaler, eliminating confusion and ensuring the right inhaler with the right medicines are used at the right time.

The management of a flare-up starts with the patient and their health-care provider recognizing the signs and symptoms and the importance of getting prompt treatment. The three major symptoms include increased breathlessness, amount or thickness of phlegm, and change in phlegm colour. Since flare-ups increase the chance of another episode that could be worse than before it’s important that people understand the need to seek medical attention quickly. If not treated early enough, exacerbations can become severe enough to require a hospital stay, and recovery may be long and difficult. In addition, frequent exacerbations are linked to faster disease progression, worsening quality of life, emotional and mental health issues, and combinations of health challenges that increase risk of death.

Another key aspect of exacerbation management is avoiding triggers, the most common of which are viruses, like a cold or flu, bacteria, and poor air quality. Viruses, in particular, are strongly connected to COPD flare-ups.

Testing to confirm diagnosis and manage disease

With close to 1.6 million Canadians believed to be unaware they may have COPD, Canadians experiencing shortness of breath, persistent cough, and excess phlegm should consult with their health-care provider, especially if they have certain risk factors, such as a history of smoking, frequent lung infections, heart problems, asthma, or a family history of lung disease. A health-care provider can order a pulmonary function test to confirm the diagnosis. With proper diagnosis and treatment, people living with COPD can better manage their symptoms and prevent flare-ups.

For these people, it’s important to ensure they get the most out of every breath. Taking a quick online symptom test could help identify how COPD symptoms affect the body and how to best seek help. Ultimately, the first step for people living with COPD is talking to their family physician and other health-care providers to learn about the options available to manage symptoms and make every breath count.

This article was made possible with support from a research-based pharmaceutical company.

References

1. Lung Health Foundation, September 19, 2022.http://www.lunghealth.ca/.
2. Ibid.
3. Ibid.
4. Ibid.