Improving Health Outcomes Through Early COPD and Asthma Intervention

Early diagnosis and treatment for undiagnosed chronic obstructive pulmonary disease (COPD) or asthma can significantly reduce health care utilization for respiratory illness and improve overall health outcomes according to research published in the New England Journal of Medicine. 

“Many persons with COPD or asthma have not received a diagnosis, so their respiratory symptoms remain largely untreated,” said researchers. 

A case-finding method was used to identify adults in the community with respiratory symptoms and no diagnosed lung disease. Participants with undiagnosed COPD or asthma were enrolled in a randomized, controlled trial to assess the impact of early diagnosis and treatment on health outcomes and health care utilization. Participants received either intervention from a pulmonologist and an asthma-COPD educator or usual care from their primary care provider. The primary outcome measured was the annualized rate of participant-initiated health care utilization for respiratory illness, with secondary outcomes including changes in quality of life, symptom burden, and FEV1.

In a study of 38 353 individuals, 595 were identified as having undiagnosed COPD or asthma, with 508 undergoing randomization. Among those randomized, 253 were placed in the intervention group and 255 in the usual-care group. Results showed a lower rate of primary-outcome events in the intervention group compared to the usual-care group, along with improvements in the St George Respiratory Questionnaire and COPD Assessment Test scores. Additionally, the intervention group saw a greater increase in FEV1 compared to the usual-care group, with similar rates of adverse events observed in both groups.

“In this trial in which a strategy was used to identify adults in the community with undiagnosed asthma or COPD, those who received pulmonologist-directed treatment had less subsequent health care utilization for respiratory illness than those who received usual care,” said researchers. 

Reference
Aaron SD, Vandemheen KL, Whitmore GA, et al. Early diagnosis and treatment of COPD and asthma. New England Journal of Medicine. 2024;391(10):967-968. doi:10.1056/NEJMc2409121