How to help patients live well with COPD

November 18, 2020 |  Nursing, Physician, Population Health, C-level

Portrait of an elder mother and daughter walking outdoorsToday is World Chronic Obstructive Lung Disease (COPD) Day, recognizing the estimated 328 million people worldwide who are living with COPD. Organized by the Global Initiative for Chronic Obstructive Lung Disease (GOLD), in collaboration with healthcare professionals and COPD patient groups worldwide, this day aims to raise awareness, share knowledge, and discuss ways to reduce the burden of COPD. COPD is a lifestyle condition that affects the lungs as a result of the long-term effects of smoking or extended exposure to air pollutants. By the time patients are diagnosed, they are typically experiencing shortness of breath during strenuous physical activity, limiting their ability to work and play. One in 20 patients admitted into the hospital for a severe COPD episode are readmitted within 30 days. 

This year, the theme of World COPD Awareness day is “Living Well with COPD - Everybody, Everywhere.” The goal of this sentiment is to send a positive message to both patients and providers that although COPD does not have a cure, patients can maintain an active lifestyle and live well by following these guidelines:

  • Learning stress management and breathing techniques
  • Enrolling in a pulmonary rehabilitation or exercise program
  • Staying up to date on your vaccinations
  • Understanding and following your medication regimen
  • Reducing your exposure to risk factors like smoking and air pollutants.

There are several ways we can help patients achieve these goals and successfully manage their COPD. The most obvious starts with prevention. COPD is preventable by decreasing exposure to air pollutants, educating our patients about the dangers of smoking, and offering smoking cessation support for those trying to quit. 

Since the majority of people diagnosed with COPD use cigarettes or tobacco, it’s important not to make these patients feel judged and to keep them engaged. Asking them where they are on their journey to quitting, and offering help at any stage along the way can help keep the door open.

Another strategy is to keep patients out of the hospital, which involves talking to them frequently and offering an action plan. The control of this disease is all about the symptoms, and part of living well with COPD is making sure patients understand what to do about worsening symptoms. Keeping symptoms under control can help patients stay out of the hospital. If not, then an action plan can still keep them out, so long as they follow it early enough and take into account any other preexisting conditions. 

Finally, knowing who my COPD patients are and having a place where my nurses and care managers can monitor them allows us to keep engaged with these patients and follow up on their outcomes. 

EHRs can help with tracking symptoms, developing and tracking action plans, monitoring outcomes, and keeping patients engaged in their care. They can also remind us about upcoming or overdue vaccinations, helping patients reduce their chances of developing a serious illness, such as those caused by lower respiratory tract infections.

The GOLD Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease was created to help clinicians focus on both the short-term and long-term impact of COPD on their patients. This system classifies COPD severity, and provides evidence-based treatment guidance to alleviate the impact of symptoms, as well as reduce “the risk of adverse health events.” GOLD’s recommendations cover diagnosis and initial treatment, prevention and maintenance therapy, and managing stable COPD.

Using GOLD’s ABCD assessment tool, providers can classify where their patient is on the complex ladder of COPD stages. Care teams have access to protocols to identify the stage and appropriate therapy, including the medications that are indicated based on the patient's stage. The guidelines can help providers create treatment plans, as well as help patients understand when to use steroid boosts or antibiotics at home.

At MEDITECH, we are actively working toward completing a COPD Management EHR Excellence Toolkit. The toolkit uses registries and advanced logic to manage patients with COPD. Additionally, health maintenance protocols track vaccinations and disease management recommendations. Clinicians benefit from workflow links to evidence-based therapeutic pathways based on the GOLD guidelines. The toolkit will leverage the sophistication of Expanse with the expertise of our Professional Services team to tailor content for each organization. MEDITECH’s COPD Management Toolkit will further assist care teams with helping COPD patients more effectively manage their symptoms, and foster the theme of “Living Well with COPD - Everybody, Everywhere” in support of World COPD Day.

Written by Steven Jones, MD, Lead Physician Informaticist, MEDITECH

Steven Jones, MD, MPH has been a Board-Certified Family Practitioner since 1999. His experience includes the full range of family practice — obstetrics, pediatrics, adolescent, adult, and geriatric medicine — whether delivered in the inpatient, outpatient, or nursing home setting. In late 2011, Dr. Jones joined MEDITECH as our lead informatics physician. In that role, he now is responsible for the development of the user experience for all of MEDITECH's physician-facing products. He also serves as the lead clinical adviser for MEDITECH's Patient Safety team, playing a central role in all quality reviews. He plays an active role on MEDITECH's Patient Safety Review Board, participates in multiple other clinical projects, and maintains his practice as a Family Practitioner in southern New Hampshire.