Lung specialists urged Filipinos living with a progressive condition known as chronic obstructive pulmonary disease (COPD) to take part in a “landmark” five-year study that is seen to yield important, still unknown data on what is considered the seventh leading cause of death in the country.
COPD patients would need to consult their nearest pulmonologists in order to be recruited for the study, whose goal is to shed light on the still unclear “local flavor” of the disease, lung doctors on Wednesday.
Launched last year, the COPD Profile and Survival Study (CPASS) of the Philippine College of Chest Physicians (PCCP) aims to gather the profiles of COPD patients across the country, compare it with those of foreign patients, look at the survival rates, and bolster research on the disease in the country, said Dr. Tim Trinidad, who chairs the Council on COPD and Pulmonary Rehabilitation of the PCCP.
“The problem is we don’t have data on COPD, with regards our local setting...so we tried doing a research,” said Trinidad. He also said the study will involve the PCCP's nine chapters and 24 training institutions.
Dr. Charles Yu, president of the PCCP, said the CPASS is “the largest study of its kind” in the Philippines. He added that it has passed an ethics review and is now in the process of recruiting subjects.
“It is going to be a five-year study—we started 2016, hopefully we will be ending 2021,” Trinidad said.
The study—funded by the Department of Science and Technology's Philippine Council for Health and Research Development—will be especially helpful because doctors in the country do not yet know just how high the prevalence of COPD among Filipinos is, or why COPD seems to be more prevalent among women.
What they do know is based on an international study that is at least 10 years old, which said that two out of 10 persons over 40 years old in Metro Manila and Nueva Ecija had COPD; and that eight out of 10 of those with the disease do not know they have it.
COPD is projected by the World Health Organization (WHO) to be the third leading cause of death in the world by 2030. COPD reportedly affects 210 million people worldwide and was also the disease that killed veteran comedian Dolphy in 2012.
Silent until substantial damage is done
COPD is a progressive lung disease that damages the lungs slowly and may not be felt by a patientuntil 20 to 50 percent of the lungs are damaged, said Trinidad.
While it is not curable, the symptoms of the disease can be treated to improve quality of life and reduce the risk of death, according to the WHO.
“Ang COPD ay isang pinsala sa daanan ng hangin o baga na karaniwang nakukuha sa paninigarilyo,” said Dr. Roland Panaligan of the PCCP when asked for a simple explanation of COPD.
It is mainly caused by exposure to cigarette smoke; biomass fuels such as firewood or charcoal; as well as air pollution and occupational dust.
CODP is not tuberculosis, which is also highly prevalent in the country, said the doctors, though it can be a combination of emphysema and bronchitis.
To a lay person, Panaligan would say the symptoms are “hapo, hingal, ubo na hindi nawawala, na may kasamang plema.”
Patients may complain of asthma but actually be diagnosed with COPD, said PCCP board member Dr. Jubert Benedicto, who also recommended attaching a prominent face—the late Dolphy, for example—to simplified explanations of the disease.
“Doon niya [patient] maiisip na, ‘naku, kung si Dolphy nga, mayaman, hindi na-spare sa COPD...’” he said.
“It’s an opportunity opening for us to tell them that you know, even if you have COPD, as long as you adhere to the medications which are available in the country...kaya pa hong magamot ang COPD,” Benedicto added.
COPD in the Philippines also goes largely undiagnosed for various reasons, which includes delayed consultations due to the cost of healthcare in the country, as well as a feeling of "comfort" with one's coughing and wheezing, symptoms of the disease, said Panaligan.
"Remember, the cost of healthcare delivery system is something out-of-pocket, so if they don’t have much money or savings for their health care, then it will really add up to the delay in terms of consultation," he said.
Majority of patients "take their symptoms for granted," too, said Benedicto.
One important way of addressing COPD is to quit smoking or to prevent exposure to noxious gases, said the doctors. There are also drugs that dilate the airways and curbs further lung damage, they said.
Raising awareness
Another strategy seen by the lung specialists to spread information about the COPD is through grassroots level awareness campaigns in barangays and municipalities, but they did not yet share details of their plans.
The PCCP on Wednesday also launched a partnership with private healthcare firm Novartis to boost their COPD awareness efforts, and to further the use of devices known as spirometers, which measure the amount of air inhaled and exhaled by the lungs.
It can be used by doctors and by lay folk who want to monitor their lung performance, said representatives from Novartis and the PCCP. A newer version of the spirometer may be connected to a mobile application for use by even non-doctors.
Novartis turned over spirometers to the PCCP, which will in turn distribute up to 650 of the portable devices to their members in the country for free-of-charge use by patients, said PCCP’s Yu.
The awareness-raising campaign, meanwhile, is called the BREATHE Initiative, which stands for Broadening Reach, Enhancing Awareness and Transforming Health Education. Novartis Philippines president Cheryl Maley said the endeavor will “ease the heavy burden [of CODP] in the country.”
The World COPD day is set to be held on November 15 and will be marked by various activities that aim to raise awareness and improve COPD care around the world.
