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Millions of Americans grapple with chronic respiratory illnesses like asthma and COPD, making every breath a challenge.
Around 27 million Americans have asthma,and another 12 million live with chronic obstructive pulmonary disease (COPD),including chronic bronchitis and emphysema. These conditions, along with seasonal allergies, are often managed by primary care physicians.
- Primary care physicians play a key role in diagnosing and managing chronic respiratory illnesses.
- Early diagnosis and structured treatment plans are crucial for those with chronic lung disease.
- Quitting smoking and getting vaccinated are essential for respiratory health.
What role do primary care physicians play in managing respiratory illnesses? Primary care physicians are vital in recognizing respiratory conditions, aiding in diagnosis, and creating treatment plans, according to Jonathan Jennings, MD, an internist with Medical Offices of Manhattan in New York City.
Getting the Right Diagnosis
Sanjay Ramakrishnan, a board-certified respiratory physician and specialist in asthma and COPD care, stresses the importance of a clear diagnosis and treatment plan for patients with chronic lung disease. He practices at Sir Charles Gairdner Hospital and The Institute for Respiratory Health at The University of Western Australia in Nedlands, Australia.
“COPD diagnosis is often delayed,” Ramakrishnan said. In the United States,it can take years for patients to receive a diagnosis from their primary care physicians.
Patients may initially experience mild symptoms such as a cough or chest infection, which could be misdiagnosed. These symptoms can sometimes worsen over several years before prompting further investigation.
Ramakrishnan suggests a spirometry test to assess lung function for patients with chronic cough and risk factors, such as a history of smoking, childhood respiratory infections, or long-term exposure to pollutants.
“This offers a safe and affordable method to glean valuable insights for their care,” he said.
Pulmonary rehabilitation is also a key part of managing chronic lung diseases like asthma or COPD, according to Ramakrishnan.
Did you know?-spirometry,a common test for COPD,measures how much air you can breathe in and out,and how quickly you can exhale. It’s crucial for early diagnosis and monitoring disease progression.
Educating Patients About Red Flags
Jennings highlights that “red-flag symptoms are not only condition-specific but patient-specific.” A clear understanding of a patient’s condition and symptoms is key to effectively controlling respiratory issues.
Common indicators of worsening disease include a cough, fever, and a more frequent need for rescue medications. Repeated COPD exacerbations also signal that more aggressive disease management is needed.
Reader question:-What strategies have you found most effective in helping patients recognize and respond to early warning signs of respiratory distress?
Ramakrishnan recommends checking blood eosinophil levels using a complete blood count, even if this was already done during a routine exam. For patients with exacerbations and elevated blood eosinophil counts (≥ 300 cells/μL),inhaled corticosteroids are recommended.Dupixent (dupilumab) may be included as an add-on treatment for some unstable COPD patients with an eosinophilic phenotype.
In a phase 3 clinical trial, Dupixent reduced COPD exacerbations by up to 34% over a year and improved lung function significantly at 12 weeks.
Ramakrishnan advises that it’s crucial to make sure patients on prednisone do not overuse it. Improperly managed prednisone use can lead to serious issues, and continued refills may suggest the disease is not adequately controlled.
Kick the Habit
The Unseen Impact: Beyond the Diagnosis
While diagnosis adn treatment are crucial, the impact of chronic respiratory illnesses, such as asthma and COPD, extends far beyond the medical realm. The constant struggle for breath can profoundly affect a person’s quality of life, impacting everything from daily activities to mental well-being.
Individuals wiht these conditions often experience limitations, impacting their ability to work, exercise, and socialize. Fatigue and breathlessness can make everyday tasks, like climbing stairs or even getting dressed, exhausting and stressful.The financial strain of managing these conditions, including medication costs, doctor’s visits, and potential hospitalizations, can also add to the burden.
What are the psychological impacts of chronic respiratory illness? Mental health is significantly affected; many patients dealing with these illnesses experience high levels of anxiety because of the fear of not being able to breathe. Depression is another common problem, as the constant physical challenges lead to isolation, and a feeling of loss of control [SAMHSA].
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