World Conference on COPD PatientsWorld Conference on COPD Patients

María Victorina López VarelaMaría Victorina López VarelaUniversity of MontevideoUniversity of MontevideoHospital MacielHospital MacielUruguayUruguay

Rome, June 2009Rome, June 2009

Brasil

Chile

Venezuela

México

Uruguay

PLATINO Menezes Lancet 2005; 366:1875

ColombiaColombia

PREPOCOL Chest 2008; 133:343

COPD: The Latin American PerspectiveCOPD: The Latin American Perspective

Cross-sectional multi-site studyCross-sectional multi-site study5 LA cities5 LA cities

Population-based Population-based Adults ≥ 40 years oldAdults ≥ 40 years old

5571questionnaires5571questionnaires5315 spirometries post BD5315 spirometries post BD

758 COPD758 COPD

PPROYECTO ROYECTO LATINOLATINOAMERICANO DE INVESTIGACION AMERICANO DE INVESTIGACION EN OBSTRUCCION PULMONAREN OBSTRUCCION PULMONAR

http://www.platino-alat.org

COPD: The Latin American PerspectiveCOPD: The Latin American Perspective

PrevalentPrevalent

Brasil Sao Paulo 15.8%

Uruguay Montevideo 19.7%

México México City 7.8%

Chile Santiago

16.9%

Venezuela Caracas 12.1%

Menezes A, et al. Lancet 2005;366:1875-81

Risk factors : smokingRisk factors : smoking biomass exposurebiomass exposure

0

5

10

15

20

25

30

35

Br Ch Mx Ur Vz

0-9,9

10-19,9

20 >

COPD: The Latin American PerspectiveCOPD: The Latin American Perspective

Under and misdiagnosedUnder and misdiagnosedUnderUnder Dx Dx COPD COPD

Mis DxMis Dx

COPDCOPD UnderUnder Dx 89%Dx 89%

Mis DX 64%Mis DX 64%

Tálamo C, et al. Chest 2007;131:60–67

COPD: The Latin American PerspectiveCOPD: The Latin American Perspective

Under and anaccurate treatedUnder and anaccurate treated

López MV, et al. Arch Bronconeumol. 2008;44:58-64

Under treated COPD (24.7%)Under treated COPD (24.7%)Unaccurate TreatmentUnaccurate Treatment

Total COPD

COPD: The Latin American PerspectiveCOPD: The Latin American Perspective

Frequent exacerbationsFrequent exacerbations

Montes de Oca M. et al Chest online

Un núExacerbations are frequent in COPD patients and related to severity

COPD: The Latin American PerspectiveCOPD: The Latin American Perspective

Underuse of spirometryUnderuse of spirometry 0

5

10

15

20

25

0--2 3--4 5--8 >9Education level (years)

%

BrasilMexicoUruguayChileVenezuela

21.3

20.6

17.8

9.6

10

Less than 20% of spirometries

COPD: The Latin American PerspectiveCOPD: The Latin American Perspective

COPD: The Latin American PerspectiveCOPD: The Latin American Perspective

What are we doing ?What are we doing ?

ALAT Educational programs / Courses : Primary carePulmonologists

ALAT ALAT EducationalEducational programsprograms / / CoursesCourses : Primary carePrimary carePulmonologistsPulmonologists

AwarenessAwareness: : CampaignsCampaigns existexistPatientsPatients AssociationsAssociations are are growinggrowing

AwarenessAwareness: : CampaignsCampaigns existexistPatientsPatients AssociationsAssociations are are growinggrowing

World Heart Federation. January, 2008

Smoking bans and cessation programs Smoking bans and cessation programs

Presenting take-home-messages from workshops

Initiating new campaigns onIncreasing awareness (diagnosis, disease, treatment)Smoking as a major causeSmoking bans in publicIntroducing the four letter abbreviation COPD to the public

White Paper:Summarizing the findings of this congress and further actions,

Conference Summary & Global Mandate

GOALS

Should be first step to fight COPD

Must be globally improved by government, health-care givers, patient organizations,

Is low among public and physicians in most regions of the world

Public campaigns and events to inform about COPD have been successfully performed

Conference Summary & Global Mandate

AWARENESS

“Tobacco smoking is linked to COPD”

Tobacco smoking is one major cause to develop COPD

Anti-smoking-campaigns and smoking bans are needed to fight COPD

There are wide regions globally where smoking is increasing and not banned

Public smoking bans can positive influence smokers habit

Smoking cessation can be achieved

Conference Summary & Global Mandate

SMOKING PREVENTION

Treatment has to be provided by government in areas, where medication is not available or too expensive for patients.

Lack of availability or unaffordability of treatment

Lack of diagnosis

Regions with:

Prevention of COPD and screening measures to better diagnose disease should be emphasized

Conference Summary & Global Mandate

DIAGNOSIS AND TREATMENT