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Because signs or symptoms are absent or ignored in most patients with mild to moderate COPD, the diagnosis is not usually made until the patient is in the advanced stages of the disease. It is of critical importance to identify and treat all patients early. These individuals are losing lung function at an accelerated rate due to smoking and other causes and are on the pathway to symptomatic COPD.
The approximately 9,000 pulmonologists in the United States do not see patients in incipient stages of the disease. These patients, often still smoking, come to the offices of their primary care physicians for various health care matters, including other smoking related diseases such as hypertension, ischemic heart disease, or other chronic illnesses like diabetes, arthritis, depression, and for minor acute illnesses. The approximately 230,000 primary care practitioners in the United States care for the vast majority of people with undiagnosed COPD. For this reason, we have developed a program for primary care practitioners to encourage early diagnosis and intervention, as well as to give a state-of-the-art review of management of all stages of COPD. Highlights of our message include the importance of office spirometry and the key importance of smoking cessation.
The National Lung Health Education Program (NLHEP) was launched in 1997 as a new health care initiative aimed at creating a national strategy for the identification and treatment of all stages of COPD. The NLHEP enjoys the sponsorship of many societies, governmental agencies and the National Emphysema Foundation. It has partnered with the American Association for Respiratory care (AARC) to jointly pursue the mission of finding and treating COPD and related disorders.