UT Medicine doctor improves treatment of COPD

Pulmonologist helps create new international guidelines for lung disease

SAN ANTONIO (Oct. 15, 2012) — After studying thousands of patients with chronic obstructive pulmonary disease (COPD), Antonio Anzueto, M.D., of UT Medicine San Antonio and an international group of health care professionals have developed new guidelines for the diagnosis of this lung disease.

As a member of the international Global Initiative for Chronic Obstructive Lung Disease (GOLD), Dr. Anzueto, professor of medicine at the UT Health Science Center, said until now, physicians have relied solely on lung function to diagnose a patient with COPD, which is the third leading cause of death in the United States.

“When deciding if a patient had obstructive lung disease, we were only looking at the lungs with a test called spirometry,” he said.

Spirometry measures how much and how quickly air is moved out of a person’s lungs. To do the test, a person breathes into a mouthpiece attached to a spirometer which is a recording device. The information collected by the spirometer can be printed out on a chart for the health care professional to review.

Dr. Anzueto, a pulmonologist, said the new guidelines recommend a physician takes into consideration two other aspects: patient symptoms and future risks of adverse events.
However, doctors have a hard time getting a true picture of patient symptoms. “Our studies showed us it is very difficult to get accurate answers about symptoms from patients. We learned that you can ask the patient about their condition and their symptoms, but you can’t get accurate answers.”

The GOLD participants suggest that health care professionals should use standardized, objective questions that are already validated in these patients to acquire information about symptoms, he said. “It is not enough to ask, ‘Are you coughing? or ‘Are you short-winded?’ They don’t always recognize these as symptoms. When patients have a cough all day every day, they start thinking that is normal and don’t realize it is a symptom,” Dr. Anzueto said.

By using these symptom tools to help in the diagnosis of COPD, Dr. Anzueto said the GOLD guidelines will result in better treatment of patients. “The health care provider can offer various forms of treatment to the patient in order to control the symptoms of COPD.”

Another important aspect of this new initiative is that health care providers also should find out if the patients had flare-ups or exacerbations of their conditions, he said. “These are what we referred to as ‘future risks of adverse events.’ We have to take into consideration that these flare-ups are events that are associated with hospitalizations and impact quality of life,” Dr. Anzueto added.

The GOLD guidelines remind health care workers that the disease is not limited just to smokers or to the lungs, Dr. Anzueto said. “People with COPD can have other conditions such as diabetes or chronic bronchitis,” he said.

More accurate diagnosing of COPD is crucial now because in the last five to six years more effective treatments have been discovered, he said. “We now have new ways to treat the disease. We have the opportunity to improve how we diagnose and treat our patients. We can impact their lives in ways we never expected. The main message is that this is a disease that can be treated.”

Dr. Anzueto said anyone 45 years of age or older who smokes needs to be evaluated for COPD. They are at an increased risk of developing or already having the disease, he explained. People who have a cough on a daily basis also should be seen by a medical expert.

UT Medicine San Antonio is the clinical practice of the School of Medicine at the UT Health Science Center San Antonio. With more than 700 doctors – all School of Medicine faculty – UT Medicine is the largest medical practice in Central and South Texas. Expertise is in more than 100 medical specialties and subspecialties. Primary care doctors and specialists see patients in private practice at UT Medicine’s flagship clinical home, the Medical Arts & Research Center (MARC), located at 8300 Floyd Curl Drive, San Antonio 78229. Most major health plans are accepted, and UT Medicine physicians also practice at several local and regional hospitals. Call (210) 450-9000 to schedule an appointment, or visit www.UTMedicine.org for a list of clinics and phone numbers.

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