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  • Writer's pictureLungtreater

Respiratory Disease Management

Disease Management: The Respiratory Population

I found Respiratory Care to be an underserved market when analyzing the approach to preventing unplanned admissions, hospital, and emergency room visits. Furthermore the markets are growing rapidly due to the prevalence of smoking and Asthma. The medical literature shows promise that better care can lead to significant reduction in these costly events. The key word is “Control.” 

Patients who engage in their care can control their disease related adverse events. Asthma for some time has been able to segment successful management and control from those suffering exacerbation of symptoms and attacks.

Programmatic approaches to COPD and Asthma have shown significant success.

So how big is the problem? 

Lets start with Asthma. In the US alone the prevalence of Asthma is 11%, meaning that 32 million Americans suffer from Asthma. The financial burden of Asthma in the US alone is approximately $144 Billion dollars per year. Within this expense one finds over 2 million unplanned emergency room visits, over 14 million unplanned physician office visits and over 340,000 hospitalizations. Asthma is the leading chronic disease in children. It is also the top reason for missed school days. Asthma is more common in boys than girls. Asthma is the third leading cause of hospital stays in children. Every other day a child dies of Asthma and every day 10 Americans die from Asthma. Most of these events are preventable and controllable!

Talking about COPD, the prevalence of COPD is much lower than Asthma but COPD is more costly per capita because COPD is a progressive “chronic” disease.  Steps can be taken to control this disease as well. There are approximately 15M people with COPD in the USA. The estimate of the annual financial burden is approximately $61 Billion. COPD is now the third highest cause of death in the US and it’s rising. Over the past 10 years the number of US women diagnosed with emphysema has nearly doubled and women are two times more likely to have chronic bronchitis than men. Today Women also have a higher rate of mortality attributed to COPD than men.

Globally COPD and Asthma is diagnosed in over 400 Million people.

So what can we do to tackle this growing problem in our society? Well its not really any different that tackling most other controllable diseases.  Also Asthma and COPD have similar signs and the pathways to control are very similar.

It begins with a plan, a COPD care plan or an Asthma Action plan. Like any plan, adherence to the care or action plan is the key. Taking a controller medication and having your rescue medication available is critical to avoiding attacks. Recognition of an individuals triggers or things that precipitate their need for rescue medications is key. Bring self-awareness of signs and symptoms to the individual as well as reporting alarming trends to the health care provider or loved ones is important. Education about the disease and what can be done to control exacerbation is also an important component of the disease management approach. Embracing the desire to change your course means everything. 

Mobile technologies are now allowing real-time coaching and caring with intelligent algorithms that monitor patients well being and encourage awareness by them, their loved ones and the caregivers. Embedding of essential devices with Bluetooth or other communication capabilities allow for important data to be gathered, reviewed and shared appropriately.

So who is to benefit from a disease management approach? Well of course the patient and loved ones; but financially it's the health care system, the payers and the pharmaceutical companies.  Peer reviewed medical literature has shown that disease management approaches particularly the reminders to take your medicine have increased the consumption of controller medications by as much as 47%.  The CDC stated in their report on Asthma (report 14-0139), “Home based systems interventions can show a return on investment; The Community Preventive Task Force documented studies that have demonstrated savings ranging from $5.30 to $14 for every dollar invested in home based Asthma interventions focused on children and adolescence.” These systems help children mitigate their triggers and manage their symptoms throughout their daily routines. Similar findings have been stated for COPD.

A Web-server based Disease Management Platform for COPD and Asthma, that utilizes mobile platforms (phones, pads) to remind people to take their medication and warn them of environmental triggers (pollen, air quality), coupled with Bluetooth embedded medical devices (spirometry) to assist people with COPD and Asthma monitor their breathing power, educate themselves regarding their disease signs and symptoms, and assist them communicate to caregivers when they find themselves in trouble, is essential to empower people achieve control over their disease.

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