People with chronic obstructive pulmonary disease (COPD) suffer from a range of troubling emotions about their condition, including frustration, anxiety and depression, as well as feelings of self-blame, according to new survey results. The findings from a national survey of 649 COPD patients also show that these beliefs can affect the way they manage their disease, highlighting potential barriers to treatment of one of the country's most common life-threatening illnesses.
 
COPD, which includes chronic bronchitis and emphysema, is a progressive disease of the airways that is characterized by a loss of lung function over time. It is the fourth-leading cause of death in the U.S. and the second-leading cause of disability after heart disease.

The survey, conducted by Emphysema Foundation for Our Rights to Survive (EFFORTS) a nonprofit patient organization dedicated to supporting and educating COPD patients, showed that COPD's emotional burden, compounded by fear and guilt, may discourage patients from seeking appropriate treatment.

Overall, COPD patients surveyed (n = 649) indicated that they most frequently felt tired, uncomfortable and frustrated. Nearly nine out of 10 reported that they think about their condition at least once a day, are concerned about experiencing an exacerbation – a worsening of symptoms that can lead to a hospital or a doctor's visit – and believe that other people think that COPD patients bring on their condition themselves. In addition, more than half reported more extreme emotions, saying that their disease "always" or "very frequently" made them feel burdened, overwhelmed, depressed, isolated, defeated, embarrassed or ashamed.

"These survey results emphasize the emotional toll the disease has on patients who live with it every day," says Gary Bain, EFFORTS president. "As a COPD patient, I understand the overwhelming burden that comes with the disease, not only because of the symptoms but also because of the stigma and stereotypes that come with it. All of these factors can profoundly impact patients' willingness to proactively manage their condition. We must correct these misperceptions and create more effective educational tools for COPD patients and the general community."

Patients who experienced the most extreme emotions may be less likely to manage their condition appropriately. Compared to other patients who did not experience extreme emotions, they were more likely to:

• Be very concerned about their condition worsening
• Think there is nothing they can do to control their condition
• Feel uncomfortable or be reluctant to seek treatment

In addition, more than nine out of 10 patients experiencing extreme emotions indicated that improving regular breathing and providing long-term relief were the most desirable characteristics of a COPD treatment. These patients were also more likely to include immediate relief as a top treatment concern. Further, they were more likely to use short-term medication, often called rescue medication, at least once a day in response to symptoms.

"These findings illustrate the fear and hopelessness that many patients feel, along with a possible emotional attachment to rescue medications," says Dennis E. Doherty, MD, professor of medicine, chief of the University of Kentucky Chandler Medical Center and Chairman of the National Lung Health Education Program, which identifies and treats patients in the early stages of emphysema and related chronic bronchitis. "While there's a role for rescue medications, maintenance therapies are more effective in managing COPD over time. Many patients, however, are confused about the role of short- and long-term treatments in managing symptoms. Physicians need to recognize the emotional aspect of this disease and better educate patients on the value of maintenance therapy so they can get the treatment they want and need."

Source: EFFORTS