After the Covid pandemic, breathing has also become more important. Three years spent alongside the SARS-CoV-2 virus have not only demonstrated that people are vulnerable, especially the elderly and frail, but have also revealed how fundamental breathing is, and that to guarantee it we must pay attention to the lungs. This is what emerges from the investigation conducted by Doxa Pharma on 100 pulmonologists to see if (and how) Covid has changed the perception – and consequently the behavior – of respiratory diseases in the Italian population, in particular COPD (Chronic Obstructive Pulmonary Disease).
by Dario Rubino
More visits to the clinic
Going into detail, 41% of the interviewees maintain that visits to the clinic in the post-emergency period have increased and 46% that this is due to greater awareness of the disease, while another 20% believe that pushing the patient from specialist is the fear of complications. Exacerbations are in fact a decisive watershed in the decline of respiratory capacity. So much so that the international Gold 2023 recommendations suggest the need to prescribe the maximum therapy, the triple therapy, already after the first episode.
But there is another fact that the investigation has brought to light: it is the gender difference. “Women (35% of patients versus 65% of men) are better at it than men – explain the authors of the survey -. They have a shorter history of illness: 9 years instead of 12. They present a less serious condition and comorbidities: disorders mood and osteoporosis, while men suffer above all from cardiovascular pathologies and diabetes. What makes the difference is the fact that women become worried at the first symptoms (41% compared to 11% of men), are more attentive to their health (here the gap is more marked: 62% versus 22%), prescriptions and doctor’s advice (39% versus 21%), are treated better (39% – 24%)”. “There is then a third element to highlight – add the experts -. COPD is not a disease for old people. The habit of smoking and the precociousness in experimenting with it have lowered the age of diagnosis to 50 years”.
by Dario Rubino
Respiratory diseases, affected half a billion people
Around the world, more than half a billion people live with chronic respiratory diseases such as asthma, COPD, bronchiectasis and other serious diseases. In Italy, 2.6 million suffer from asthma, 3.3 million suffer from COPD, while more than 50 thousand suffer from lower respiratory tract infections and over 60 thousand suffer from lung cancer. Adding these data we find ourselves faced with the third cause of death on the planet, with an estimate of more than 50 thousand deaths per year.
Even from an economic point of view, the budget is heavy: direct and indirect costs amount to 45.7 billion euros (medical care, loss of working days, decrease in productivity, consumption of drugs and oxygen). Numbers increasing due to the progressive aging of the population and growing smokers. According to data from Smoking report in Italy by the Istituto Superiore di Sanità, presented last year on the occasion of the World No Tobacco Day, almost one Italian in 4, 24.2%, is a smoker: a percentage that has not been recorded since 2006.
COPD, more attention to treatment
COPD, like all chronic respiratory diseases, experiences the paradox of being among those with the most effective treatments, but usually ignored by those involved: often taken when needed, and then left in moments of lull in the symptoms. It was the pandemic that awakened some attention. But the picture that Doxa Pharma shows presents large shades of grey. Eight out of 10 pulmonologists confirm that Covid has brought about a change in the management and treatment of COPD patients. The biggest problems are follow up (57%), referring patients to their attention (42%) and diagnosis (28%). Greater awareness or apprehension has, on the other hand, changed the doctor-patient relationship for 40% of those interviewed, the patient who first and foremost asks to be reassured: this is said by 23% of clinicians, who undergo check-ups more frequently ( 10%), also through telemedicine (13%).
The sore point patient journey
Furthermore, for 6 out of 10 pulmonologists the most negative notes come from the patient journey. Despite a greater demand for diagnostic tests (18%), there are still long waiting times (38%) and difficulties in accessing spirometry (18%). And this is what patients’ requests are based on: reduction of waiting lists (42%), resumption of adequate follow-up (21%), the eternal theme of early diagnosis (15%). For specialists, the priority is to increase monitoring (35%), spirometry first of all, but also other tests; reduce waiting times for visits (30%). Furthermore, the desire of 16% for a more centralized general practitioner should be highlighted.
So what to do? 79% of those interviewed think that it is necessary to structure a healthcare network that sees close collaboration between local and hospital healthcare. The same percentage believes that it is a good idea to rethink local healthcare and the related methods of taking care of patients with COPD. Finally, one in two also looks at digital tools and adequate infrastructures to be able to provide adequate support and responses to patients.