For Health Professionals

Why worry about COPD? COPD is: 

  • The fourth leading cause of death in the United States
  • The fourth leading cause of disability in the United States
  •  A largely preventable disease
  • A major driver of avoidable healthcare costs

In New Hampshire:

  • Approximately 130,000 NH adults have COPD but half of them are undiagnosed
  • COPD prevalence varies widely ranging from 4.1% in Cheshire County to 11.3% in Coos County.
  • Only 35% of those diagnosed with COPD, were referred to Pulmonary Rehabilitation
  • COPD prevalence increased with age and is higher in groups with lower income and education levels

"As with any chronic disease, early and correct diagnosis is important for several reasons.  It is especially important to distinguish those folks with asthma, versus COPD, versus the 10-20% with overlap of both diseases. Treatment for these diseases uses many of the same medications, but order of use is very different and can lead to major complications if used inappropriately." - Albee Budnitz, MD, FACP, FCCP

Causes of COPD

In nearly all cases, COPD is caused by long-term inhalation of lung irritants that damage the lungs and airways. The most common irritant is cigarette smoke. Pipe, cigar, and other types of tobacco smoke can also cause COPD, especially if the smoke is inhaled directly or from secondhand smoke.

Breathing in secondhand smoke, air pollutants or chemical fumes or dust in the home and workplace environment can also contribute to COPD.

Rarely, a genetic condition called Alpha-1 Antitrypsin deficiency may play a role in causing COPD. People who have this condition have low levels of alpha-1 antitrypsin (AAT), a protein made in the liver. Having a low level of the AAT protein can lead to lung damage and COPD if a person with this condition is exposed to smoke or other lung irritants. COPD can worsen very quickly in smokers who have AAT deficiency.

Symptoms of COPD

  • Chronic cough
  • Chronic sputum (phlegm) production
  • Shortness of breath while doing daily activities
  • Inability to take a deep breath
  • Wheezing

Diagnosis and Treatment

Early detection is critical in determining the progress of COPD and achieving better health outcomes for the patient. A simple test called spirometry is used to measure lung function and confirm diagnosis. Classification of the severity of COPD is based on post-bronchodilator spirometry.

While COPD has no cure yet, treatment is available to manage symptoms, to slow the progress of the disease and to improve the patient's quality of life. The goals of effective COPD management include: 

  • Relieving symptoms
  • Slowing the progress of the disease
  • Improving exercise tolerance and ability to stay active
  • Preventing and treating complications and exacerbation
  • Improving overall health

Treatment options include (Treatments are added at greater degrees of severity):

  • Smoking cessation
  • Medications
  • Pulmonary rehabilitation
  • Physical activity
  • Oxygen supplementation

Comorbidities Associated with COPD

People with COPD often live with other diseases or comorbidities such as asthma, diabetes, congestive heart disease or mental health diseases. It is recommended that health care providers actively identify these comorbidities in COPD patients since they often complicate the clinical management of the disease and can contribute to the overall severity of the disease.

Additional Resources for Providers 

  1. COPD Action Plan (Writable pdf)
  2. COPD Clinical Guidelines (ACP) (pdf)
  3. COPD Insurance/Medication Form (Writable pdf)
  4. NH COPD Plan Details 

Learn More

  1. National Heart, Lung and Blood Institute (NHLBI)
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