More than 70,000 West Australians have COPD, but half are unaware they have it, writes respiratory physician Dr Sanjay Ramakrishnan.
Chronic obstructive pulmonary disease is the number one cause of preventable hospitalisations in WA and a change is needed not only in how we approach education, but in how we activate, mobilise and direct the community towards lung function testing for correct diagnosis.
COPD affects about one in four West Australians over the age of 65. It is estimated that about half of people living with COPD are unaware they have the disease, and in my experience many sufferers only seek help once their daily lives are significantly impacted, which can be during later stages of the condition.
A lack of general awareness and knowledge, coupled with an acceptance of reduced baseline health, can mean critical delays in diagnoses and treatment.
An estimated $831.6 million was spent on treatment and management of COPD in 2020-21, which represents 0.6% of overall health system expenditure. Disease burden is greatest in remote and regional populations and in lower socioeconomic areas, potentially adding to barriers to accessing treatment.
Indigenous Australians are 5.4 times more likely to be affected, highlighting a critical need for targeted population-based interventions. Whether mild, moderate or severe, a COPD diagnosis diminishes quality of life, most acutely when paired with comorbidities.
Following the release of Australia’s first COPD Clinical Care Standards, the 22nd World COPD Day launched a call to action for the general community, ‘Know Your Lung Function’.
With the welcome establishment of the standards comes a set of 10 simple goals that any service helping people with COPD needs to meet. Are they tested and diagnosed? Is their treatment enough? Are they being seen quickly enough?
These standards also speak to the importance of lung function testing, a set of gold standard diagnostic tools and markers that can help identify COPD often before quality of life is significantly impacted. It allows people to kick-start proactive management, preventing further deterioration.
These tests involve traditional spirometry, but may also include gas exchange, lung volume tests, exercise tests and others.
While many patients view a COPD diagnosis as a slow but terminal progression, it is critical that we impart the message that severe and frequent exacerbations are not inevitable and that research and new trials into the use of drugs like monoclonal antibodies continue, with constant improvements to the way we are treating the disease.
It is positive to see LFTs offered as a fully bulk billed service by Respiratory Care WA, where I am a member of the Clinical Advisory Group.
This is a crucial step in helping to break down barriers to early diagnosis.
My research has included focus on understanding and mitigating COPD flare-ups as well as ensuring existing management methods are being adequately utilised. Collaborating with global experts, at the University of Oxford, King’s College London and University of Sherbrooke, Canada, I have seen how proactive care can help people regain control over their lives.
Early symptoms of COPD are often put down to ageing or a sedentary lifestyle, and sufferers are found to dismiss breathlessness or fatigue as “just part of getting older”.
This misconception, among other reasons, can stop them from seeking help until the disease has significantly progressed. But here is where we must reassure our patients; understanding what is happening in their lungs is the first step toward breathing easier—both literally and figuratively.
ED: Dr Sanjay Ramakrishnan is a clinical advisor at Respiratory Care WA.
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