A Physician’s Tale

  • Video transcript | 2:38

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    TALES OF BREATHLESSNESS

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    A PHYSICIAN’S TALE

    Identifying COPD patients who remain symptomatic despite maintenance treatment with an ICS/LABA

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    There are people you meet throughout your career who you never forget. For me, it was James–a patient I diagnosed with COPD some time ago.

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    Whenever I asked how he was doing on his maintenance medication, he said he was feeling fine.

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    So it came as a shock when James’s wife wanted to come to one his appointments and told me the full impact COPD was having on their lives.

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    His wife told me James was coughing and wheezing more and experiencing shortness of breath…

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    …which made climbing stairs and carrying out daily tasks more difficult.

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    His symptoms were also causing him to wake during the night…

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    …and leaving him nervous about leaving the house.

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    That’s when I realized that James hadn’t been giving me the full picture.

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    And if I didn’t reassess his maintenance treatment, his symptoms could continue to worsen and lead to an exacerbation.

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    Even when they were prescribed FP/SAL, an ICS/LABA, nearly 90% of patients with COPD had a high symptom burden (CAT≥10)*

    *Based on data from an observational claims-linked survey of Medicare Advantage enrollees ≥65 years of age who had been prescribed FP/ SAL in the prior 6 months (n=397).

    Study Limitations: A claim for a prescription does not necessarily mean the medication was taken as prescribed. Diagnosis codes on medical claims do not conclusively demonstrate presence of disease. Findings may not be generalizable to uninsured or younger patient populations.

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    COPD exacerbations may be underreported by patients, which could lead to undertreatment of COPD.

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    Up to half of COPD exacerbations may go unreported,* making it harder to assess a patient’s future exacerbation risk.

    *Based on data from a 12-month study of patients with moderate to severe COPD (N=70).

    An exacerbation was defined as worsening symptoms, compatible with a reported exacerbation, for at least 2 consecutive days.

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    There are some things that can help you see the full picture of their COPD.

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    Since then, I’ve changed my approach. To find out how COPD is really impacting patients, I have specific questions I make sure I ask during appointments that require more than just ‘yes’, ‘no’, or ‘ok’ responses.

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    How do your symptoms affect your daily activities?

    How often do your symptoms cause you to wake up at night?

    How do your symptoms affect how far you can walk or how many stairs you can climb?

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    Some patients don’t always notice their symptoms are getting worse as it can happen gradually, so I ask them to keep a note of them.

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    But even then…

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    …it’s not always easy.

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    James has helped me to see the importance of COPD management…

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    …and timely optimization of treatment.

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    And to always try to get the full picture of how COPD is impacting my patients and their loved ones.

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    And to never just accept ‘I’m fine’.

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    Even if some of your patients tell you that they’re doing ‘okay’ on an ICS/LABA, it’s important to investigate deeper. You might not be getting the complete picture of how COPD has impacted their lives.

    Trademarks are owned by or licensed to the GSK group of companies.

    [GSK logo]

    ©2021 GSK or licensor. FVUVID210025

    October 2021 Produced in USA.

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    References

    1. Moretz C, et al. Int J Chron Obstruct Pulmon Dis. 2020;15:2715-2725. Supplementary Table 1.

    2. Pavord ID, et al. Int J Chron Obstruct Pulmon Dis. 2016;11:21-30.

    3. GOLD. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. 2021 report. www.goldcopd.org

    4. Seemungal TAR, et al. Am J Respir Crit Care Med. 1998;157(5):1418-1422.

    Definitions

    CAT=COPD Assessment Test; COPD=chronic obstructive pulmonary disease; FP=fluticasone propionate; GOLD=Global Initiative for Chronic Obstructive Lung Disease; ICS=inhaled corticosteroid; LABA=long-acting beta2-adrenergic agonist; SAL=salmeterol.

     

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