Educating cardiologists on COPD management to improve CVD outcomes

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is common among patients with cardiovascular disease (CVD), and in fact nearly a third of patients with COPD die of CV causes. Thus, increased screening and evaluation of patients with comorbid COPD and CVD is important and has the potential to improve CVD outcomes. Aims and objectives: This online point-of-care program aimed to empower cardiologists to screen and evaluate their CV patients both at risk of COPD or with COPD. The goals were to ensure COPD was correctly diagnosed, identify patients needing improved COPD control, and prompt cardiologists to refer to a respirologist when appropriate. Methods: 36 Canadian cardiologists completed surveys on up to 20 patients at risk of COPD (age ≥40 years, a smoking history of ≥10 pack-years, and ≥1 positive answer on the Canadian Lung Health Test), or with a current diagnosis, during routine visits. After entering a patient profile, the program prompted physicians with relevant information and recommendations. Results: Cardiologists entered 588 patients into the online program. Compared to the group with COPD, patients at risk of COPD were more likely to present with new or worsening CV symptoms (38% vs. 21%). Of the 143 patients at risk of COPD, 62 were newly referred for spirometry, and 43 were referred to an HCP for evaluation/confirmation of COPD. Out of 445 patients with COPD, 134 had not had spirometry to confirm diagnosis, while 42 were newly referred for confirmation of COPD. Conclusion: Increased awareness of the presence of or potential for COPD among cardiologists9 patients led to positive clinical change in the form of referrals for diagnosis or management of COPD.