Q&A: Enhancing COPD Management by Eliminating Barriers

Photo Credit: Rost-9D

Researchers studied the most effective interventions to improve COPD care, emphasizing self-management education, Tai Chi, and telehealth use.

Although chronic obstructive pulmonary disease (COPD) is a prevalent and debilitating disease state with treatment advancements in constant evolution, there are still significant barriers to achieving optimal care.

Damian Chi Hong Siu, MPH, OTD candidate, and his supervisor, Liat Gafni-Lachter, OTD, PhD, sought to categorize and address these barriers while offering a three-point initiative to improve patient care. They published the findings of their review in the International Journal of Chronic Obstructive Pulmonary Disease.

Dr. Siu spoke with Physician’s Weekly (PW) about his research.

PW: Why did you feel this topic needed exploration?

Dr. Siu: COPD is a well-known chronic disease. It is usually underestimated in terms of the functional impact it has on activities of daily living. Compromised daily living is a multifactorial condition attributed to suboptimal COPD management. Poor COPD management leads to an increased risk of acute exacerbation of COPD and mortality.

Although there are many puff medications [ie, inhalers] available for the control of COPD, patients’ personal preferences, physical condition, financial restrictions, and family support are also important factors that need to be considered. Further studies are needed to explore the solutions to optimize COPD management.

What are the most important findings from your study for physicians to understand?

In addressing the barriers to managing COPD, my review highlights three evidence-based solutions for managing the disease effectively:

1. Self-management education
2. Health Qigong (Tai Chi)
3. Adopting a telehealth format in addition to a conventional face-to-face format

Evidence has suggested that training using a telehealth platform showed effectiveness similar to face-to-face training and that the telehealth format would improve participants’ completion and attendance rate.

How can these findings be incorporated into practice?

I recommend clinical efforts to develop a multidisciplinary COPD self-management program using telehealth. Both synchronous and asynchronous formats need to be explored given financial or resource implications. Several evidence-based health resources, such as Living Well with COPD, are available in different language formats.

What makes this issue particularly urgent in the healthcare landscape?

COPD is a prevalent disease, and it has the highest rate of hospital readmission. If patients are empowered and educated on how to manage it well, I am confident that the rate of hospital readmission will be significantly lower.

What would you like future research to be focused on?

Future research should study the effectiveness of multidisciplinary COPD self-management training in primary care delivered via telehealth. Future efforts should also focus on developing a cost-effectiveness analysis of the telehealth training program, especially in rural areas.

What else would you feel PW readers benefit from knowing about your research?

Optimal management of COPD is multifactorial, and practitioners need time and effort to address patients’ desires and expectations. My research highlights three categories of evidence-based solutions, and I suggest readers include the solutions in their clinical practice. I expect more patients with COPD will benefit and promote their self-efficacy in managing the disease.