Description
Chronic Obstructive Pulmonary Disease (COPD) is the third leading cause of all deaths in the U.S., the most recent available data showing it was the primary cause of death for >76,000 women and >68,000 men 45 and over in 2013 (CDC Wonder accessed on September 24, 2015). The disease affects a large portion of the adult U.S. population, 6.5% of those aged 25 years and older, corresponding to approximately 14million people (60% of whom are women), according to data obtained through the CDC Behavioral Risk Factor Surveillance System (BRFSS) for 2011 and the default intercensal population data. This high COPD prevalence translates into frequent physician office and emergency department visits and hospitalizations (see report and data).
COPD is a multifaceted disease, and, while mostly related to present or past cigarette smoking, approximately 15% of COPD occurs in individuals who have never smoked. There are gender and racial/ethnic differences in COPD prevalence and mortality. Characteristically, the individual with COPD is also affected by a variety of comorbid conditions that require precise, patient-tailored approaches to treatment. The disease is responsible for frequent hospital and intensive care unit (ICU) admissions, and it decreases the likelihood of employment of the affected individuals, causing them to rely on the support of family caregivers. Societal costs associated with COPD reached over $32 billion annually in direct health care costs and another $20 billion in morbidity and mortality (2010 data).
The huge burden of COPD within the US population has prompted long-standing research efforts both in the US and abroad and these have led to significant improvements in diagnosis and therapy for the disease. Notwithstanding these successes, the current epidemiological data clearly underscore the need for additional efforts to develop and implement new coordinated preventive, diagnostic, and therapeutic approaches.
The importance of COPD to the health of the nation was highlighted by the Senate Appropriations Committee in FY2012 with the encouragement to the NHLBI “to work with community stakeholders and other federal agencies, including CDC, to develop a national action plan to respond to the growing burden of this disease”. A letter from Reps. Lewis, Joyce and Shea-Porter on November 2014 to the CDC Director, Dr. Thomas Frieden, and the NIH Director, Dr. Francis Collins, requested “that the NIH and the CDC create a National Action Plan for COPD in fiscal year 2015”. The reply from both Directors assured the members of Congress that “in late 2015, the NHLBI will be convening a meeting involving federal and non-federal stakeholders, including patients and their family caregivers, to develop a National Action Plan to coordinate activities targeting this disease”.
In response to these requests and in collaboration with CDC and other federal partners, the NHLBI -- the NIH component with primary responsibility for lung diseases -- previously organized two trans-governmental preparatory workshops to discuss the structural and scientific environment for a COPD National Action Plan 2013 and 2014. As a follow-up to those two workshops, and in preparation for convening a meeting involving both federal and non-federal stakeholders, including patients and their families, NHLBI organized on September 10, 2015 an additional conference call among federal partners. The objective was to plan a public COPD Town Hall Meeting that will begin to shape a COPD National Action Plan. This report provides a summary of that September 2015 meeting.