Inhalers are part of the treatment options for COPD.
Inhalers are part of the treatment options for COPD.
Leading New Zealand health expert Lutz Beckert wants a new Australian Government standard of care for chronic obstructive pulmonary disease (COPD) - a condition and the fourth leading cause of death in New Zealand - adopted here.
COPD refers to diseases like chronic bronchitis and emphysema that cause airflow blockage and breathing-related problems. It is estimated to affect approximately 200,000 New Zealanders aged over 45.
The disease is inequitably borne by Māori and Pasifika people who are more likely to be diagnosed with, and more severely impacted by COPD. The disease may be underdiagnosed with approximately 70% of people worldwide.
Beckert, Professor of Medicine at the University of Otago, says the new COPD Clinical Care Standard, launched last month by the Australian Government, will reduce hospitalisation and improve outcomes for those with the disease.
He says adopting the new Australian standard could present an opportunity for New Zealand to review its own approach to COPD patient care and consider whether this standard should be introduced here.
Dr Lutz Beckert, Professor of Medicine at the University of Otago.
“Ensuring access to lung function testing i.e. spirometry is one of the key tenets of the new Australian Standard and given the high prevalence of the disease here, I believe funded spirometry should be available through every New Zealand GP - in the same way we have access to funded testing for diabetes or breast cancer.
“In Australia the new Standard identifies 10 critical areas of care essential for assisting those living with COPD, helping them manage symptoms and enhance their quality of life,” Beckert said.
“COPD has no cure, the Standard offers various strategies to relieve symptoms, reduce exacerbation risks, lower hospitalisation rates and improve quality of life.
Beckert says we also need to raise awareness of COPD as an occupational lung disease.
“Exposure to vapours, gas, dust or fine particles (VGDF) in some occupations increases the chance of lung disease by 40%.
“Smoking alone increases the chance of lung disease by 280%. However, the combination of smoking and VGDF exposure at work increases the chance by 620%.”
Respiratory specialist Dr James Wethasinghe says COPD has not been given the focus it perhaps should because many of those diagnosed feel a sense of shame due to smoking.
“Without intervention, the disease can severely impact someone’s quality of life, with daily activities like simply walking a flight of stairs or a small hill extremely difficult,” he said.
“Breathlessness is one of the main symptoms. So are recurrent chest infections and limited functional capacity. Patients often find they cannot do as much physical work. It troubles them because they were able to do so much more and all of a sudden they have to change the way they live their life. Without these faculties, life can become very insular and patients often feel isolated and alone.
Māori at risk
“Hospitalisation rates for Māori are nearly four times as high as those of European or other ethnicities (excluding Asian and Pacific people).
“Respiratory disease cost New Zealand $8 billion in 2019 - yet there is always room for better utilisation of funding in this area. We need more clinicians, nurse specialists and greater access to diagnostics.
Wethasinghe agrees that earlier intervention is key in identifying and treating the disease and calls for greater access to spirometry to ensure patients are captured as early as possible.
Amanda Southcombe, GSK NZ general manager, says funding for Trelegy Ellipta was recently announced, a single inhaler triple-therapy to treat the disease, which will see around 15,000 Kiwis suffering from moderate to severe COPD now able to access.
