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    COPD patient education needs, challenges: What health execs should know

    Education is a key component of patients taking ownership of their chronic obstructive pulmonary disease (COPD). Yet survey data shows there needs to be more disease-state education for patients and providers.

    HanHanThat’s according to MeiLan King Han, MD, associate professor of pulmonary medicine at the University of Michigan in Ann Arbor and a spokesperson for the American Lung Association.

    “I think it can be really tough for physicians to provide education when patient visits are so short. We simply do not have the amount of time we would like to spend with our patients,” says Han. “And even with more time, it is difficult to cover every facet of the disease in a single office visit.”

    The goal, Han says, is for the patient to understand as much as they can about the disease so they can cope with it and to feel empowered to live their healthiest life.

    Education should include information about medications, oxygen, and what to do if patients have a flare-up of respiratory trouble, also called exacerbations, she says, adding that the role of vaccinations and medications in preventing exacerbations is also an incredibly important message to convey to patients.

    To learn more about specific COPD patient education needs, Managed Healthcare Executive (MHE) asked Han to identify more of the critical education needs and challenges. 

    MHE: What should be emphasized in patient education?

    Han: Patients have a lot of educational needs that are frequently difficult to meet within a short span of an office visit.  Helping patients gain a basic understanding of COPD and how medications can help them manage their disease will hopefully improve adherence. 

    Patients also need to be properly trained in using their respiratory medication inhalers. This is best done in the office, so the patient can actually demonstrate that they know how to perform the technique, as there are many types of devices on the market.  Formularies change constantly and, unfortunately, so do medications and the accompanying device. This is often out of a physician’s control.

    The 2017 update to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) recommendation is to check proper inhaler technique.

    Smoking cessation counseling is also a key piece of education for patients who are currently smoking.  For patients using oxygen, education about equipment and managing oxygen during travel can also be incredibly helpful. 

    One potentially good way for patients to receive COPD education is pulmonary rehabilitation. The American Lung Association and the COPD Foundation also have great educational materials on their websites.

    MHE: Is exacerbation management a foundation of patient education as well?

    Han: Yes. You want to help patients to know what signs of exacerbation are and what to do if they were to have them. I try to equip patients with a COPD action plan. It is important that the patient knows what symptoms to look for and who to call if they develop breathing trouble.

    MHE: How does patient education impact COPD hospital admissions and readmissions?

    Han: I am unaware of any data that would suggest that education alone is going to necessarily prevent an admission or prevent a readmission. But I do think education is a significant element of providing comprehensive care, which hopefully will ultimately prevent admissions and readmissions. 

    One of the challenges health systems face is that education is not well reimbursed in the outpatient setting. The concept of Patient-Centered Medical Homes, which are not COPD-specific, are one place where there is better reimbursement infrastructure for providing care coordination, including education. But in general, reimbursement for staff to provide patient education remains challenging.

     

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