Experts are sounding the alarm about “tripledemia”, managed by a spike in Covid-19 cases accompanied by a especially challenging flu season and spike in RSV hospitalizations. As the weather turns colder, people living with chronic obstructive pulmonary disease (COPD) and their caregivers must contend with a fourth risk in addition to these simultaneous waves of respiratory illness. Just as respiratory illnesses typically follow a seasonal trajectory, the colder months also correlate with a marked increase in COPD exacerbations occurring twice as often than during the summer months. People living with COPD need proactive support from their care teams to manage their condition and stay afloat during the crashing waves of the upcoming ‘COPD season’. Payers and providers must come together to make this proactive support possible.
We have seen how quickly Covid-19 can push hospitals to the brink as it drains the resources and bandwidth of our healthcare system. With flu hospitalizations on the rise and COPD exacerbations leading to more than 700,000 hospitalizations in the United States each year, it’s not hard to imagine a huge winter for our health care system. Beyond the strain these spikes put on bed capacity and provider burnout, an uncontrolled COPD season can take a painful financial toll on our system. A quarter of COPD patients discharged after exacerbation readmitted within 30 days and COPD patients readmitted to hospital account for $15 billion in US health care costs each year.
I saw this first hand while working as a hospitalist – patients with COPD kept going to the emergency room with exacerbations, never getting the care they needed between those visits. Considering the increased frequency of exacerbations during the COPD season and the fact that exacerbations contain With 70 percent of costs associated with COPD, the winter months seem even more challenging.
But these harsh predictions are not written in stone. COPD season doesn’t have to knock us down. Despite popular misconceptions, COPD can be proactively managed before patients reach the point of exacerbation. It’s a tall order, but we have the tools we need to change the paradigm of care.
First, by investing in preventive care, we can protect our health care system from being overwhelmed this winter. Encouraging proactive COPD care over a reactive framework—one that largely consists of hospitalizations and emergency department visits—is fundamental to strengthening our health care system and helps alleviate pressure on bed capacity and care providers in the midst of the convergent jumps.
Second, we can expand virtual capabilities to bridge care gaps and provide patients with access to effective therapies and resources from the comfort of their own homes. Because the severity of COPD symptoms often affects mobility, many people find themselves housebound as the disease progresses, making access to care even more difficult. Evidence assumes that integrated COPD care can reduce 30-day hospital readmissions by up to 57 percent, and using virtual tools to connect patients with that care can help ensure they have the resources and support to stay healthy and outside the hospital.
Third, we need to facilitate the improvement of COPD self-management. In the hospital, we often sent discharged patients home with reading materials designed to guide them in their self-management, but it was so clear when they ended up back in the emergency room that this alone was not enough to produce lasting behavior change. Integrating regular coaching into a patient’s care can help them make a connection between their actions and their health, build their confidence and improve their self-efficacy so they can better manage their COPD.
Finally, we need to encourage coordination and increase visibility among providers. This means prioritizing proactive information sharing between patients and their treatment teams to manage COPD before it gets worse. This is particularly important in relation to traditions of care where the needs of vulnerable patients can fall through gaps in care.
Colder weather will always pose an added risk for people with COPD, but this COPD season doesn’t have to be so harmful. To turn the tide, payers and providers must invest in preventive care to meet patients where they are before their condition worsens. Investing now will make our healthcare system more resilient, reduce unnecessary costs, keep patients healthy and avoid repeating the patterns of past seasons.
Photo: milan2099, Getty Images