Smoking a major risk factor in COPD
PCCP, DOH release guidelines to arrest prevalence of disease
EMPHYSEMA and chronic bronchitis both fall under Chronic Obstructive Pulmonary Disease (COPD) — a long- term lung condition that causes patients to suffer from breathlessness and chronic cough, severely affecting their lifestyles and productivity.
Normally suffered by those who smoke or exposed to fumes, COPD is fast becoming the third leading cause of death worldwide and seventh in the Philippines. This has motivated the government, medical professionals and the private sector into instituting proactive measures to arrest the alarming prevalence of lung disease in thecountry.
A major component of these initiatives is the crafting, dissemination and implementation of the “Philippine COPD Guidelines/ Pathway” spearheaded by the Philippine College of Chest Physicians ( PCCP) and the Department of Health ( DOH).
According to PCCP immediate past president Lenora Cañizares- Fernandez, the “guidelines will become the standard clinical approach in the detection, diagnosis, and management of COPD across all levels of health care.”
Incorporated in the Universal Health Care ( UHC) Act, implementation will be from the primary care at the local government unit ( LGU) level up to the specialists.
The initial phase of the draft, which is meant for primary health care providers, or the so- called “front- liners,” has already been submitted by the PCCP to the DOHEssential Non- Communicable Diseases Division ( ENCDD).
“Our guidelines for the primary health care level has been reviewed by the DOH- ENCDD and can aid in the care of COPD patients at the frontline,” Fernandez said.
The next phase of the COPD Guidelines/Pathway, she added, is meant for the specialists.
“There are only about 800 COPD specialists in the country, so we need the help of all the doctors, especially at the primary health care level,” she noted.
‘COPD Day’
Former President Gloria Macapagal- Arroyo, who is intent on increasing COPD awareness in the country, signed a proclamation declaring every third Wednesday of November as the National COPD Day, coinciding with the World COPD Day. This year’s theme is “All together to end COPD!”
PCCP, in cooperation with UAP, a division of leading pharmaceutical and healthcare company, Unilab Inc., and other partners, are now conducting seminars, fora, and meetings with stakeholders to drum up awareness for the disease and the COPD Guidelines.
Major risk factor
Fernandez pointed out that according to recent studies, COPD is now the seventh-leading cause of mortality in the Philippines with cigarette smoking as the major risk factor for the disease.
Prevalence among adults was already at 14 percent as of 2007, and projected to increase rapidly because there are still around 16 million Filipinos who smoke.
“COPD can become apparent in smokers 10 to 20 years after the start of smoking. With the number of Filipinos smoking still high, the prevalence of COPD in the country will continue to grow in the next 10 to 20 years too,” Fernandez said.
Fernandez disclosed that even non- smokers develop COPD in the Philippines. These include members of households that depend on firewood and charcoal in cooking their food and those who are exposed to dusty jobs.
Device needed to detect disease
Detection of the disease — and relatedly its proper reporting — has been a major problem in the country, mainly because of the inaccessibility of devices that detect COPD in most areas of the country.
The spirometer, an apparatus that measures the movement of air into and out of the lungs, costs around P200,000 per unit. This apparatus is not available in most medical facilities at the primary care level, and even in some private diagnostic centers.
Fernandez said patients who undergo spirometry pay around P600 to P4,000, depending on the hospitals and diagnostic centers. Hopefully, she said, DOH will provide spirometer to all hospitals maintained by LGUs, using funding from the UHC Act.
At the level of health centers, Fernandez said the DOH needs to provide a Peak Flow Meter, a much cheaper handheld device that measures how fast air moves out of the lungs.
“We will train barangay health workers how to use spirometers, Peak Flow Meters and even inhalers,” she Fernandez said.
Consistent with the UHC Act, Fernandez added that they hope that PhilHealth will extend its coverage for COPD to include outpatient care, diagnosis, and medicines. Philhealth only shoulders COPD- related health expenses during confinement.