COPD is on the European Commission’s agenda, EU health chief says

Vytenis Andriukaitis: "I am promoting very much spirometry because it is a very cheap and good instrument." [Sarantis Michalopoulos]

This article is part of our special report The true face of the second leading cause of death.

Diagnosis tools like spirometry should be promoted in order to monitor lung systems and prevent the spreading of illness like chronic obstructive pulmonary disease (COPD), the second cause of death worldwide, the EU’s Health Commissioner Vytenis Andriukaitis told EURACTIV.com.

“I am promoting very much spirometry because it is a very cheap and good instrument. We have enough science, evidence showing that those results can help monitor the lung systems,” the Lithuanian Commissioner said.

The main advantage of these medical devices is that they help diagnose COPD early on, he explained.

“I count on the European network on prevention of pneumonic diseases and of course on the possibilities to once again raise the question on such a diagnostic tool, and enshrine them in the area of primary care,” he insisted.

The European Federation of Allergy and Airways Diseases Patients’ Associations (EFA) has been particularly vocal in demanding a better harmonisation of care standards for COPD patients by reinforcing preventive measures.

That means including spirometry in general health check-ups and supporting patients’ rehabilitation and quit-smoking programmes across the EU.

EU's approach to COPD remains focused on tobacco control

Despite alarming figures, the European Commission does not plan specific targets or a harmonised approach for the prevention of chronic obstructive pulmonary disease (COPD). Instead, it says it will ensure tobacco control policies are properly implemented in the member states.

On 23 November, the European Commission presented a report conducted together with the OECD and the European Observatory on Health Systems and Policies, at a Brussels event.

The EU executive pointed out that reducing the burden of avoidable diseases on healthcare systems was high on the EU executive’s agenda.

Andriukaitis: National health systems need 'fundamental reform'

EU countries could save money and lives by increasing investment in disease prevention and health promotion, the European Commission said on Thursday (23 November), stressing that good health policy requires political will across all sectors.

Spending on prevention accounts for only 3% of national health budgets, compared with 80% on the treatment of diseases, a situation that is clearly unbalanced, according to the Commission.

Speaking on the sidelines of the event, Andriukaitis told EURACTIV.com that COPD is in the Commission’s plans. “No doubt we have to discuss those issues in the Steering Group on Promotion and Prevention.”

“We will see how to discuss those issues in the Steering Group on Promotion and Prevention, just established, and to propose to member states how to tackle those issues in their primary care system,” the EU health chief said.

The Steering Group on Promotion and Prevention, is composed of representatives from all EU countries and was established by the Commission to support member states in meeting the WHO/UN 2025 global voluntary targets on non-communicable diseases.

COPD patients need power 

Patient organisations agree with the Commission’s focus on strict preventive measures like tobacco control policies. However, they point out that once someone has been diagnosed with COPD, they are left alone. For these patients, prevention is about stopping the disease from progressing.

COPD patients lack oxygen so their respiration is like breathing through a straw, EFA explained.

Depending on the progression of the disease, patients may not be able to do ordinary things like walking or even standing. For them, the lack of oxygen can soon become a spiral that affects their whole body. And the more time patients remain sedentary, the higher the risk of death.

Almost one to two out of 10 Europeans aged over 40 are COPD patients who generate €48.4 billion annually in EU healthcare cost.

Organisations highlight the need for patients to be empowered, with tools ranging from education about the disease to developing expertise and self-managing.

They argue that COPD patients should be able to decide for themselves about their treatment.

“COPD can be a scary and depressing diagnosis. Your life is turned upside down in that consultation. If healthcare professionals don’t have the time to explain that life is possible with COPD and that the disease may slow down from harming the lungs, patients can lose confidence and start isolating,” EFA Director Susanna Palkonen told EURACTIV.

She cited Sweden as an example, saying patients there are referred to COPD schools where they learn about the disease. They can build their own coping strategies and meet other patients and healthcare professionals who support them and motivate them.

“It’s about patient empowerment, giving patients the power to fight COPD, through knowledge and informed choice of treatment. To breathe, to live, to work to enjoy. Each COPD patient will develop their own strategy but to get there, patients need to be in the driving seat to deal and move on with COPD. They need to feel the power that they are in control of their lives”, she explained.

In order for patients to take control of their disease, they need to strengthen their muscles and train their lungs to get the maximum oxygen in. According to EFA, this could be done via motivation, targeted exercise and m-health applications.