Symptoms such as shortness of breath while exercising, chronic cough, wheezing, or pressure in the chest may indicate that whoever is affected by them has chronic obstructive pulmonary disease, or COPD.
The main cause that contributes to its development is smoking, although there are other influencing factors, such as environmental pollution and certain specific personal characteristics, such as abnormal lung development.
In Spain, 29,000 people die each year from this disease, making it the fourth leading cause of death. But, undoubtedly, one of the great problems in this regard is underdiagnosis, since it is estimated that three out of four patients do not even know that they suffer from this ailment, which translates into under-treatment. All of this leads medical professionals to view COPD as a public health problem. “It is a preventable and treatable disease,” says Julio Ancochea, head of the Pneumology Service at Hospital La Princesa in Madrid, who believes that it is essential to emphasize its prevention.
“The COPD-tobacco binomial is practically indissoluble, since in Spain approximately 80% of those affected by chronic obstructive pulmonary disease are or have been smokers,” says the pulmonologist, who also indicates that it tends to develop “in the fifth or sixth decade of the life”.
Dr. Ancochea is blunt: ” In the event that symptoms such as difficulty breathing appear when exerting physical effort, accompanied by coughing, in people over 35 years of age who smoke more than one pack a day, a bronchodilator spirometry should be done , which is the test that makes it possible to establish the diagnosis of epo c ”.
In this way, if the ailment is detected at an earlier stage, it will be easier for the specialist to find a treatment that helps to attack it and mitigate the symptoms. And, as Ancochea indicates, “the underdiagnosis of COPD in our country stands at 74%.” For this reason, the pulmonologist indicates that one of the challenges to address this disease is “to make spirometry more accessible in the field of primary care.” If the disease is diagnosed early, it is relatively easy to slow its progress.
The problem can occur when the evil progresses without being treated. “It is a disease with frequent extrapulmonary manifestations and risk of developing other conditions associated with COPD itself or related to aging and smoking,” says the specialist. Some of these collateral ailments, according to Dr. Ancochea, could be “cardiovascular disease, lung cancer and the development of other types of tumors.” In addition, with the passage of time, the symptoms can increase, so that he urges to intervene early ” to prevent the patient from being affected by a degree of disability that prevents him from working .”
As for the itinerary to follow to carry out the treatment, Ancochea is clear about the first stop: stop smoking. “It is what has been shown to really modify the natural history of the disease and improve the quality of life,” he says. From there, live healthy, exercise and get vaccinated every year against the flu and pneumonia.
In addition, the pulmonologist insists on the need for patients to follow the treatment correctly. In fact, according to data from the Observatory of Adherence to Treatment, half of patients with COPD do not comply with the guidelines set by the doctor. According to Dr. Ancochea, treatment in COPD is “increasingly personalized”. To decide the most appropriate for each patient, variables such as risk level and phenotype are analyzed, which are the characteristics of each organism.
Three better than one, but in one take
For patients affected by exacerbations or acute episodes of symptoms, those who suffer from a combined syndrome of COPD and asthma, or with features typical of chronic bronchitis or emphysema, the pulmonologist Julio Ancochea indicates that it is essential to combine different drugs.
One of the great advances in COPD in recent years is the development of triple therapy, which combines three key drugs based on a combination of corticosteroids and bronchodilators. They have been shown to significantly improve the effectiveness of treatment over those that were previously available. One of the problems generated by the fact that a patient has to resort to different treatments is the so-called lack of adherence: speaking clearly, not taking all the doses that are prescribed.
To that end, two inhaler presentations are now available containing this triple therapy in one device, to be used once or twice a day. ” Inhaled medication is key. We need to have devices that help the patient to be constant by simplifying their administration ”, emphasizes Dr. Ancochea. The scientific evidences of the benefits that this treatment brings are more than proven. Dr. Ancochea emphasizes that “dyspnea improves – choking or shortness of breath – which translates into a higher quality of life for patients, and also increases survival rates.”
By Nieves Sebastián
