Photo Credit: DonkeyWorx
A simple, easy-to-use tool such as the COPD Exacerbation Recognition Tool (CERT) may help to alleviate this issue.
Every chronic obstructive pulmonary disease (COPD) exacerbation has the potential to cause the patient lasting harm and/or a long recovery period. A physician’s guidance can help temper and alleviate an episode’s repercussions. However, if the physician is unaware of the exacerbation, how can they address it?
In studies, patients have given many reasons as to why they refrain from reporting a COPD exacerbation. Identifying these excuses and eliminating under-reporting would contribute to more efficient care and better outcomes. Paul Jones, MD, and colleagues developed a comprehensive literature review to investigate the obstacles in how patients with COPD report their exacerbations. In addition, Dr. Jones and colleagues examine the viability of the COPD Exacerbation Recognition Tool (CERT) to spur productive reporting of episodes to appropriate healthcare practitioners. CERT is a five-item questionnaire that helps with effectively recognizing and reporting COPD exacerbations. One of the advantages of using CERT is that it provides simple descriptions of exacerbations that are accessible to the average patient with COPD.
COPD: Journal of Chronic Obstructive Pulmonary Disease published the observations gathered from this literature review. The review found that the factors responsible for the under-reporting of COPD exacerbations by patients could be broadly characterized under the following: lack of patient comprehension, overall attitude toward the disease state (ie, dislike of seeking medical care and preference to self-medicate), demographic influences (ie, socioeconomic concerns, age, sex, race, and smoking status), and lack of access to useful tools. Dr. Jones and colleagues concluded, “It is clear that the challenge of underreporting and delayed reporting of exacerbations is multifactorial and will necessitate a multipronged approach for the solution.”
Physician’s Weekly (PW) spoke with Dr. Jones about the importance of reporting COPD exacerbations and the insights from the review.
PW: Why did you feel this topic needed exploration?
Dr. Jones: Patients with COPD under-report their exacerbations, which is very important because each of these episodes has a cumulative effect on lung function and health-related quality of life.
What are the most important takeaways from your review?
This review summarizes what is known about the reasons why patients under-report their COPD exacerbations. It’s a worldwide problem. It further describes the development of a patient education tool that may encourage patients to report their exacerbations with greater accuracy.
How can these findings be incorporated into practice?
Healthcare providers can give their patients the CERT with the explanation that if their symptoms worsen at any time and they meet the criteria in the tool, they should seek advice because the episode may signal the onset of an exacerbation that requires treatment.
What makes this issue particularly urgent in the healthcare landscape?
Unreported exacerbations are untreated, resulting in slower and potentially incomplete recovery. In addition, the healthcare professional is not aware that the patient is having exacerbations that may require the addition of maintenance preventative treatment.
What would you like future research to be focused on?
First, we need to know more about why patients don’t report exacerbations. Second, we need to test whether the use of the CERT increases the reporting of exacerbations and whether this will, in turn, improve long-term outcomes.
