CME: Identifying Smoking-Related Disease

CME: Identifying Smoking-Related Disease

Among current and former adult smokers, symptoms like productive cough, dyspnea, and exercise intolerance may be viewed as a part of normal aging, particularly among older former smokers. Smoking cessation may reduce respiratory symptom severity and slow the rate of lung function decline, but it does not eliminate progressive lung disease risk. Few studies have assessed the effects of smoking on patients without COPD. A group of researchers has suspected that spirometry may be insensitive to early disease or subclinical lung pathology and that current and former cigarette smokers without spirometric evidence of COPD may have impairments in physical function, quality of life, and respiratory symptoms that can go untreated. High-resolution CT scanning in this patient population may demonstrate significant lung disease, but comprehensive data has been lacking. Finding Hidden Lung Disease “There are no disease-modifying treatments for patients identified with smoking-related lung disease,” explains Elizabeth A. Regan, MD, PhD, “but there are many treatments that improve their symptoms, allow them to breath better, enable them to exercise, and improve quality of life.” For a study published in JAMA Internal Medicine, Dr. Regan and colleagues set out to determine whether or not patients with a heavy smoking history, but who did not meet spirometric criteria for COPD, had hidden lung disease. Dr. Regan and colleagues completed evaluations on more than 10,000 current and former smokers aged 45 to 80 with at least a 10 pack-year smoking history and a comparison group of more than 100 never smokers of similar ages. Evaluations included high-resolution chest CT scans, spirometry, 6-minute walking tests, and multiple questionnaires about respiratory symptoms, comorbidities, and quality...
Identifying Smoking-Related Disease

Identifying Smoking-Related Disease

Among current and former adult smokers, symptoms like productive cough, dyspnea, and exercise intolerance may be viewed as a part of normal aging, particularly among older former smokers. Smoking cessation may reduce respiratory symptom severity and slow the rate of lung function decline, but it does not eliminate progressive lung disease risk. Few studies have assessed the effects of smoking on patients without COPD. A group of researchers has suspected that spirometry may be insensitive to early disease or subclinical lung pathology and that current and former cigarette smokers without spirometric evidence of COPD may have impairments in physical function, quality of life, and respiratory symptoms that can go untreated. High-resolution CT scanning in this patient population may demonstrate significant lung disease, but comprehensive data has been lacking. Finding Hidden Lung Disease “There are no disease-modifying treatments for patients identified with smoking-related lung disease,” explains Elizabeth A. Regan, MD, PhD, “but there are many treatments that improve their symptoms, allow them to breath better, enable them to exercise, and improve quality of life.” For a study published in JAMA Internal Medicine, Dr. Regan and colleagues set out to determine whether or not patients with a heavy smoking history, but who did not meet spirometric criteria for COPD, had hidden lung disease. Dr. Regan and colleagues completed evaluations on more than 10,000 current and former smokers aged 45 to 80 with at least a 10 pack-year smoking history and a comparison group of more than 100 never smokers of similar ages. Evaluations included high-resolution chest CT scans, spirometry, 6-minute walking tests, and multiple questionnaires about respiratory symptoms, comorbidities, and quality...
A Look at Recidivism in COPD Management

A Look at Recidivism in COPD Management

COPD is a group of progressively debilitating respiratory conditions, including emphysema and chronic bronchitis, and it ranks as the third leading cause of death in the United States, according to the CDC. About 16 million Americans are currently diagnosed with COPD, but another 14 million or more remain undiagnosed. In addition, COPD accounts for nearly 2 million ED visits each year, but much of this data is confounded by asthma admissions. “COPD patients who require ED attention or hospitalization are those with the most severe disease,” explains Reynold A. Panettieri, Jr., MD. “Furthermore, hospitalization and ED visits for COPD are more often clustered in the winter. They are associated with exposure to viruses and bacterial pathogens.” People aged 50 and older are more likely than others to get COPD, but the damage starts years before these individuals are diagnosed and can progress even after smoking cessation. Since the disease occurs and is diagnosed later in life, the risk of COPD is especially high for patients older than 45 with a smoking history. Healthcare Utilization & Readmission for COPD Most patients with diagnosed COPD report that symptoms of their disease impair their quality of life, but only about half take at least one daily medication for COPD. The healthcare utilization rate for COPD patients is also substantial. About one in five COPD patients visits an ED or is admitted to a hospital for care within a year. “The bottom line is that patients, providers, and the healthcare system cannot afford recidivism for COPD hospitalization.” Recidivism in healthcare has been defined as the tendency by ill patients to relapse or return...