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Obstructive Lung Diseases |

Chronic Obstructive Pulmonary Disease (COPD) Impairs Breathing Related Activities, Exacerbates Negative Emotions, and Creates Healthcare Needs at the Cincinnati VAMC

Aaron Mulhall*, MD; Laura Lach, RRT; Sara Krywkowski-Mohn, EdD; Panos Ralph, MD
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Department of Internal Medicine. University of Cincinnati Academic Health Center, Cincinnati, OH


Chest. 2012;142(4_MeetingAbstracts):722A. doi:10.1378/chest.1388543
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Abstract

SESSION TYPE: COPD Posters I

PRESENTED ON: Wednesday, October 24, 2012 at 01:30 PM - 02:30 PM

PURPOSE: COPD is a common disorder of veterans that causes significant morbidity and mortality. To address the self-identified healthcare needs of veterans with COPD, we designed a postal survey to measure veterans’ perceptions about COPD, the effect of COPD on their health, and their needs for improved health.

METHODS: Using findings from focus groups of veterans with the greatest healthcare utilization, we developed a COPD Health Determinants Questionnaire. Veterans were stratified by COPD healthcare cost into quintiles, and uniformly sampled from highest to lowest cost of COPD care. The questionnaire was mailed to 1000 of the 3263 patients with a diagnosis of COPD.

RESULTS: Respondents completed and returned 493 of the 1000 surveys (49%). There were differences between the top and bottom quintiles regarding knowledge of COPD diagnosis (89% vs 73%, p=0.03), the effect of COPD on breathing related activities (work [69% vs 45%, p=0.02], recreation [85% vs 62%, p<0.01], change in living arrangements [36% vs 16%, p=0.04] and increased need for help [54% vs 25%], p<0.01), and emotions (fear [41% vs 15%] and helplessness [49% vs 24%]) . 50% of the patients were informed of their COPD diagnosis by a Primary Care Physician (PCP), and 40% felt their PCP’s were the best educators about COPD and its treatment. 90% of patients were prescribed inhalers, and 20% had difficulties using them. 25% of patients reported that no COPD treatment options had been discussed with them, and 25% did nothing when they had symptoms of an exacerbation. 50% of patients waited until their next PCP appointment to ask questions about their COPD or its management.

CONCLUSIONS: COPD has profound effects on veterans’ breathing related activities and emotions. PCP’s are critical in conveying the diagnosis and education of COPD.

CLINICAL IMPLICATIONS: These findings will inform the development of a patient-centered COPD management program that will address patients’ needs as well as the biomedical and physiological manifestations of COPD.

DISCLOSURE: The following authors have nothing to disclose: Aaron Mulhall, Laura Lach, Sara Krywkowski-Mohn, Panos Ralph

No Product/Research Disclosure Information

Department of Internal Medicine. University of Cincinnati Academic Health Center, Cincinnati, OH

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