At the seminar on Progress in Respiratory Diseases Professor Trevor Jones from King’s College London presented the estimated future impact by COPD. His claim was that by 2030 it will be the 3rd largest cause of death in Europe. In Sweden already today 3000 every year die from COPD. The cause is smoking, basically its smokers cough, so no real positive change in incidence rate can be expected in the near future. And with no known cure there is no reason to doubt his figures.
At the same time I always hesitate when I hear about the new threat that we all will die from. These type of estimations are quite common in Brussels – and btw the media. Most disease areas have representatives that fully credible manage to claim that specific disease area is the one that really will be the most heavy burden for society in the future. Now they cannot all be right can they? (Swine Flu, SARS etc) And if they are not all right does this mean that they are just crying wolf?
Yes and no. They do cry wolf since its estimations and not known facts and it’s not possible that more than very few of the diseases will actually be the most costly and problematic disease area. Some because other disease areas increase of importance are not part of their calculations. Some because with new innovation and general development they will just not be as burdensome as calculated with current knowledge. But I would also say no they do not cry wolf because the wolf actually do come and we only see a positive development in some are because they got attention and the issue where dealt with in time. There are good examples of when things were taken seriously early enough and we can in retrospective see the benefits for the health budgets.
Also at the seminar where leading expert in Asthma Professor Stephen Holgate at the University of Southampton and Susanna Palkonen who is the Executive Officer of the European Federation of Allergy and Airways Diseases Patients. I come across these two earlier when I attended the Summit for Change in Asthma in 2006 and have with interest followed the work in this field. Especially the Finish experience that Susanna used as a good example in her presentation. Professor Tari Haahtela presented this work in Brussels at an event I attended last year. What Finland did was creating a long-term strategy to ensure better care for the patients at a lower cost for society. It’s a cross sector effort being calculated and evaluated cross sectors beyond the regular healthcare silos. In short I would describe the efforts as that they by increasing the knowledge in the healthcare sector about Asthma and thereby ensuring more regular visits to the GPs and healthcare centres in combination with an increased use of pharmaceuticals (basically double the spend on both these part of the care) the Finns where during a 10 year time able to cut the total cost for asthma management. The cost where saved on less days of sick leave, early retirement and hospital days. Something that beyond the positive effects it had on the state budget also of cause meant quite an improvement in the quality of life for the patients!
Now we will have to see if we could have similar efforts in the area of COPD – there is quite a lot to be done and the postcode lottery is widespread. The Health consumer Powerhouse have looked into the various regions in Sweden and compared the support given and found a lot of differences. I’m know that if similar criteria’s for example with regards to help to smoking cessation would be measured country by country in Europe one would find that it’s not that many countries that actually actively help their citizens stop smoking. But if the right levels listens to Jones we should be able to ensure that we never have to face the a situation where COPD is the 3rd largest cause of death in Europe.
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The Swedish study this year by Health Consumer Powerhouse found a significant spread among the 21 healthcare regions with regard to awareness, focus and methodology for treating COPD. Some regions put the well-being of their patients at risk by being less able than others in making the appropriate diagnosis; COPD is often confused with asthma. The impact from best practice and treatment guidelines was surprisingly weak, telling us there is a lot of postcode lottery also in Swedish COPD care. Smoke cessation policy and support reveal significant inequalities around the country. As probably less than half of the Swedes suffering from COPD are yet identified by healthcare - and of course even fewer have a proper diagnosis - this is a kind of time-bomb. Professor Jones is right about the menacing trend; COPD is a major health threat especially to women. In many EU countries you have the reason to suspect that awareness is still quite low and the gender aspects lacking. As "inequalities in health" will become a major EU priority a reality check on COPD policy and care would be essential to move this huge and growing disease from silence to activism!
ReplyDeleteJohan Hjertqvist
Health Consumer Powerhouse
Bah!
ReplyDeleteThat doctors, professors and politicians claim that just their area is important, will be even more important in the future and therefore need huge amount of money is standard. Sometimes they are right, but in 99% of the cases they are soooo wrong.
Lets check the facts about death: http://en.wikipedia.org/wiki/Causes_of_death.
COPD is responsible for 4,8% of all deaths in the world, and number eleven in size. Lets drop the deaths of infectious diseases, AIDS and other things that european seldom dies of, and COPD would still have to pass three of five big killers: cardovascular diseases, ischematic heart diseases, accidents, cancer and stroke.
This at the same time that smoking actually is dwindling down in the developed world? Not to mention that smoke-free alternatives are on the march, like wet (Swedish) snuff or non-burning cigarettes? Sounds unlikely.
Todays deaths from COPD were founded when TV characters chain-smoked, when it was OK to smoke in other peoples homes and when many work places were covered in smoke. I strongly suspect that the number of COPD deaths will fall in absolute numbers fairly soon.
If professor Jones wants to do good he should start working in China and places where smoking acutally is rising.