CINCINNATI—The prevalence of chronic obstructive pulmonary disease, or COPD, in the Greater Cincinnati area is among the highest in the U.S.
Now, with the help of a $250,000 educational grant from Pfizer Pharmaceuticals, faculty educators at the University of Cincinnati and community health organizations are forming an interdisciplinary partnership to improve the care of patients with this serious lung condition.
COPD refers to chronic bronchitis and emphysema, two commonly co-existing diseases of the lungs in which the airwaysbecome narrowed. The condition gets worse over time and causes difficulty breathing, coughing that produces large amounts of mucus, wheezing, chest tightness and other symptoms.
Cigarette smoking is the leading cause of COPD.
Jack Kues, PhD, project director and assistant senior vice president for continuous professional development (CPD), says the UC Center for CPD will coordinate an initiative to reduce gaps in disease knowledge and care of COPD and promote overall improvements for treatment.
“We are developing teams comprised of various specialties,” Kues says. “Between now and December 2010, the teams we develop will focus on best treatment practices, creating an interdisciplinary approach to COPD care. This will result in better coordinated care and communication among the various care providers.”
These teams will consist of patients, physicians and pharmacists from the community and from the UC Academic Health Center’s four colleges.
Kues says Phase I of this trial was conducted in 2008 with the help of a $364,240 grant from Pfizer and Boehringer Ingelheim Pharmaceuticals. The study involved focus groups with care providers and interviews with patients and their families about COPD care.
Initial results showed poor communication between primary care providers and pulmonologists, underutilization of pulmonary rehabilitation and few smoking cessation programs integrated into the care model.
“In addition, spirometry assessments are rarely done to confirm diagnosis,” Kues says, noting that these breath tests measure lung function, specifically the amount and speed of air that can be inhaled and exhaled. “This is the best way to confirm COPD in a patient.”
As part of Phase II, Kues says designated teams will use evidence-based management to improve communication and coordinate care more efficiently.
“We will also work to screen smokers and others at risk for COPD and educate patients on the illness,” he says. “We will use pharmacists to explain the proper use of pulmonary medicines with coordination of health care providers, integrate smoking cessation programs into care and create appropriate referral practices to pulmonary rehabilitation programs.
“This new model of care will result in improved availability of a greater array of services, thus enhancing the quality of COPD patient care.”
Ralph Panos, a UC Physicians and Cincinnati Veterans Affairs Hospital pulmonologist, who is on the steering committee for the project, says that as a lung specialist, he sees evidence daily that the need for comprehensive COPD care is dire.
“COPD is the fourth-leading cause of death in the Cincinnati area,” he says. “This sort of care model will ensure that patients are getting the best possible treatment by not only educating them about their illness but also by creating an open discourse between the primary care physicians and specialists.”
He adds that this will also serve as an education tool for health care providers.
“We often work in a silo,” he says. “This will help teach or refresh health experts on other disciplines.”
Kues says Phase III of the project will assess the impact of the disease interventions put into place during Phase II and aid in development of an ongoing system for improvement of COPD care.
“We hope this program will serve as a guide to other communities and regions outside of Cincinnati looking to implement a coordinated model of care for this patient group,” he says.
Partners in this effort include UC’s Academic Health Center, including the colleges of medicine, nursing, pharmacy and allied health sciences, local primary care practices, Kroger Pharmacy, Christ Hospital and the American Lung Association.
Physicians involved in this program cite no conflict of interest with Pfizer.