The three years of Pandemia from Sars-Cov-2 not only said we are vulnerable and that someone-the elderly, the fragiles-are more than the others. They also made us discover the importance of our breathing and that we need to pay attention to the health of our lungs. This is the first data that catches the eye when analyzing the survey conducted by Doxa Pharma on 100 pulmonologists to see if (and how) Covid has changed the perception – and consequently the behavior – of respiratory diseases in the Italian population, and particularly COPD.
41% of the interviewees – reports a note – declare that the access accesses in the post -emergency period increased and 46% that the reason is to be ascribed to a greater awareness of the disease, while another 20% say that to push the patient to the specialist is the fear of complications. Exacerbations are in fact a decisive watershed in the decline of respiratory capacity. So much so that the international Gold 2023 recommendations even suggest the need to prescribe the maximum therapy, the triple therapy, already after the first episode.
The other figure on which the spotlight is immediately worth pointing is the gender difference. Women (35% of VS 65% patients are better than men, but this is not new. They have a history of lower disease: 9 years compared to 12. They present a less serious condition and comorbidity: mood and osteoporosis disorders, while men suffer above all of cardiovascular and diabetes pathologies. To make the difference is that women worry about the first symptoms (41% against 11% of men); They are more attentive to their health (here the gap is more marked: 62% vs 22%); To the prescriptions and advice of the doctor (39% compared to 21%), they care better (39% – 24%). The third element that emerges from the study – continues the note – is that COPD is not a disease for old people. The habit of smoking and earliness in turning the cigarette (and we will see in some time the consequences of the surrogates) has lowered the age of diagnosis to 50 years.
Nel mondo più di mezzo miliardo di persone convive con malattie respiratorie croniche come l’asma, la Bpco, la bronchiectasia e altre gravi patologie. In Italia – dettaglia la nota – sono 2,6 milioni quelle che soffrono di asma, 3,3 milioni di Bpco, più di 50 mila presentano infezioni delle basse vie respiratorie e oltre 60 mila sono malate di cancro ai polmoni. Therefore, we are faced with the third cause of death on the planet, with an estimate of more than 50 thousand deaths per year. Che equivale a costi diretti e indiretti pari a 45,7 miliardi di euro (assistenza medica, perdita di giornate lavorative, diminuzione della produttività e consumo di farmaci e ossigeno). Numeri in aumento, a causa dell’invecchiamento progressivo della popolazione e al numero in crescita dei fumatori. Secondo i dati del Rapporto sul fumo in Italia dell’Istituto superiore di sanità, presentati in occasione della Giornata mondiale contro il tabacco, quasi un italiano su 4, il 24,2%, è un fumatore: una percentuale che non si registrava dal 2006.
The pandemic therefore awakened some attention. And this is certainly a good thing. But the picture that Doxa Pharma shows presents large shades of grey. Let’s resume the story. Eight out of 10 pneumologists confirm that Covid has induced a change on the management and treatment of patients with COPD. The greatest problems are follow-up (57%); sending patients to their attention (42%); the diagnosis (28%). Greater awareness or apprehension has, on the other hand, changed the doctor-patient relationship for 40% of those interviewed. Patient who first asks to be reassured: 23% of clinicians say it; It undergoes more frequently controls (10%); also through telemedicine (13%).
For 6 out of 10 pneumologists, the most negative notes come from the ‘Patient Journey’. In the face of a greater demand for diagnostic tests (18%), there are still long waiting times (38%) and difficulty in accede to spirometry (18%). And it is on this that the requests of the sick are recorded: reduction of waiting lists (42%), recovery of an adequate follow-up (21%), the eternal theme of early diagnosis (15%). For specialists, the priority is to increase monitoring (35%), spirometry first of all, but also other exams; Reduce waiting times for visits (30%). It is worth highlighting the hope of 16% for a more central role of the general practitioner. Not only. 79% believe that it is necessary to structure a welfare network that sees the close collaboration of territorial health with the hospital. The same percentage, consistently – concludes the note – thinks that it is good to rethink the health of the territory and the related methods of taking charge of patients with COPD. One in two also looks to digital tools and adequate infrastructure to be able to give adequate support and responses to patients. Women are mainly in therapy with double bronchodilation (Laba+Lama), men with the triple (ICS+Laba+Lama).
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