great benefits in screening undiagnosed cases and educating patients

great benefits in screening undiagnosed cases and educating patients
great benefits in screening undiagnosed cases and educating patients

Screening undiagnosed cases of asthma and chronic obstructive pulmonary disease (COPD) and offering patients treatment that includes an educational component could improve the quality of life of these patients while reducing health care costs. This is what a study suggests, the results of which were published on May 19 in the New England Journal of Medicine by a research team, including Louis-Philippe Boulet and Andréanne Côté, from the Faculty of Medicine of Laval University.

Between 2017 and 2023, this team conducted a telephone survey which allowed them to identify 5,631 people who were experiencing respiratory problems (cough, shortness of breath, wheezing, copious production of phlegm), but who had never received a diagnosis. of pulmonary diseases. Of these, 2,857 people agreed to take a spirometry test, which involves expelling the largest possible volume of air in one second. This test made it possible to determine that 595 of these people, or 21% of the cohort, suffered from asthma or COPD.

“It is possible that some of these people did not consult doctors because they judged that the symptoms they were suffering from were common respiratory problems. It is also possible that another part of these people saw a doctor, but as too often happens, they were prescribed treatment without having carried out a test confirming the diagnosis of asthma or COPD,” explains Professor Andréanne Côté, who is also a pulmonologist and researcher at the Research Center of the University Institute of Cardiology and Pneumology of Quebec.

The research team then asked 508 subjects to participate in the second part of the study. These people were subdivided into two groups: patients in the first group were referred to a family doctor who provided them with the usual treatment for these respiratory problems, while patients in the second group benefited from treatment based on recommended care guidelines for asthma and COPD, provided by a multidisciplinary team. “The nurses and respiratory therapists on the team were responsible for meeting patients to explain the nature of their illness, good lifestyle habits to adopt, how to make good use of their pump and how to manage periods of exacerbation of their illness in addition to offering them support for smoking cessation,” specifies Professor Côté.

In the year that followed, there was half as much use of medical services – medical consultations and hospitalizations – by subjects in the education group as by those in the usual treatment group. Furthermore, subjects in both groups experienced improvements in the quality of life and the functional capabilities of their lungs, but these benefits were significantly more marked in subjects in the group who received education.

“ The educational intervention requires between 60 and 90 minutes per patient. Its cost quickly pays for itself when you consider that hospitalization for COPD can cost between $10,000 and $15,000. »

— Andréanne Côté

“Our study delivers two messages,” summarizes Professor Côté. The first is that if you have symptoms that match those of asthma or COPD, it is worth seeking care because intervention can change the trajectory of the disease and improve your quality of life. The second is that the educational component produces substantial benefits both for patients and for the health system. The educational intervention requires between 60 and 90 minutes per patient. Its cost quickly pays for itself when you consider that hospitalization for COPD can cost between $10,000 and $15,000. Ideally, diagnosis by spirometry and educational intervention could be done on the front line, by family doctors and their team.”

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