Earlier this year, Kenneth Cohen, MD, Chief Medical Officer at New West Physicians in Colorado, and his associates studied COPD and looked for ways to enhance patient care. They decided to incorporate the COPD Population Screener™ (COPD-PS), endorsed by the COPD Alliance, to facilitate the early recognition of COPD in their at-risk patients.
When he learned about the COPD-PS, Dr. Cohen and his associates immediately saw its value. Knowing the importance of early intervention with tobacco cessation, they embedded it in the vital signs section of their electronic health records and required at-risk patients to answer the screener questions at every visit.
“If we get a score of five or greater in a patient not previously diagnosed with COPD,” said Dr. Cohen, “we initiated a process whereby we then perform spirometry. So far, we have used it only in the office setting, but we are considering using it at health fairs.”
Since Dr. Cohen’s practice began using the screener only relatively recently, it is too early to note how much impact has been made. However, he noted that, by using spirometry, patients who demonstrate an elevated lung age are more motivated to quit using tobacco. Although, Dr. Cohen added, “Those who see normal lung function seem lulled into thinking they are escaping the health hazards of tobacco. That makes it important to have a screening tool to decide who should receive spirometry testing. The screener allows us not to waste resources or drive up health-care costs by doing spirometry in patients where it may not be indicated.”
“The key benefits of the screener are that it has been validated and it can be quickly administered by a medical assistant or self-administered by the patient,” said Dr. Cohen. “Lastly, patients can lose as much as 50% of lung function without developing symptoms. This makes early diagnosis important. “
Dr. Cohen added, “Even though treatment has not had a great impact on the progression of COPD, tobacco cessation does make an impact, and we need to know for whom to maximally target our efforts.”
The New West Physicians group is not the only group to see patient benefits from the use of the screener. David Dotson, DO, a primary care physician with the McLaren Family Care Center in Michigan, began using the COPD-PS earlier this year at the encouragement of a pharmaceutical representative. He now personally distributes it to patients he suspects could have COPD and uses it several times a week.
Once office spirometry confirms a patient’s COPD diagnosis, Dr. Dotson performs pulmonary function testing and make sure the patient starts receiving appropriate therapy. Prior to using the screener, his resources were more limited. “If a patient had COPD but seemed more symptomatic, I would look at the forced expiratory volume, or FEV1, level and monitor it to see if the patient’s condition was declining or improving,” he explained. Occasionally, he sees a patient who is already seeing a lung specialist for a different problem, and he finds the screener useful in working with them, as well.
“I find the questionnaire especially handy for use with current smokers and for those who recently quit smoking,” said Dr. Dotson. “I use it with new patients to assess their risk for COPD.” He added, “Given the nature of COPD, they may not see immediate results, but they can see gradual benefits in the long run. Intervening earlier with appropriate management can help patients feel better with more energy and may reduce the number or severity of exacerbations.”
Dr. Dotson has already seen great improvement in a current patient identified after completing the screener. “When the patient began receiving [medication], I monitored him at every visit and could see his FEV1 going up and pulmonary function test scores going down. He can now perform activities he could not do before, and he feels much better.”
Now that he has been using the COPD-PS, Dr. Dotson strongly encourages his colleagues to use it, as well. “As a tool, it is very simple to use and very useful.”
Awareness and education are key factors in making a positive impact on the lives of patients with COPD. Follow the lead of the COPD Alliance by taking the first STEP toward helping improve your patient’s lives.
- S – Screen patients at risk
- T – Test and diagnose using spirometry
- E – Educate patients about COPD
- P – Provide care and support
Are you ready for COPD Awareness Month in November? Take the first STEP to becoming COPD Prepared by downloading and using the COPD Alliance endorsed screener now.