The director of the Canary Islands Health Service, Conrado Domínguez, and the general director of Health Programs of the SCS, Elizabeth Hernández, presented the document on Wednesday Integrated health care process of the epoc in the Canary Islands to improve the results and reduce the morbidity and mortality of patients with chronic obstructive pulmonary disease from a greater coordination between the different levels of the public system.
During his speech, Conrado Domínguez explained that the objective of creating this care route is to improve the identification of patients with COPD and to promote the early diagnosis of this disease to reduce its incidence and morbidity, which will result in greater quality of life, detailed from the Ministry of Health of the Government of the Canary Islands.
The epoc is a chronic and progressive respiratory disease whose The main cause is tobacco and is characterized by a limitation to air flow that is not reversible and with a symptomatology of dyspnea, cough and expectoration, they added by means of a press release before remembering that it is a frequent pathology, more prevalent at older ages and associated with other ailments with aging. .
The disease presents a high morbidity and mortality, constituting the fifth cause of death among Spanish men and sixth in women, completed from Health to place, according to the estimates of the World Health Organization (WHO), as the third cause of death on the planet during 20132.
Elizabeth Hernández explained that in the Canary Islands, although the prevalence in people between 40 and 80 years of age is lower than in Spain, with 7% compared to 10% national, the comorbidity is higher, particularly in hypertension, dyslipidemia, ischemic heart disease and cardiac arrhythmia, which causes an increase in the consumption of health resources, said the general director.
In addition, the epoc has an important impact in terms of economic cost and deterioration of the quality of life of the person suffering from the disease and their relatives since, according to data from the Hospital morbidity survey of 2016, supposes globally the 2.04% of all hospital discharges, coded at 2,837 during that year in the Canary Islands.
"In the National strategy of epoc It is estimated that in Spain there would be around 270,000 patients diagnosed and treated", informed Hernández.
Tobacco is the most important risk factor in the development of the epoc and, given that it is an incurable disease, the approach to smoking to prevent it is an essential part to reduce its incidence, stressed the same sources.
The smoking cessation is the most effective measure to prevent it and slow down its progression, in addition to the only method along with the oxygen therapy that has been shown increase survival, they pointed from the SCS before considering the association between tobacco consumption and epoc irrefutable.
In Spain, tobacco causes 60,000 deaths each year, placing it as the most important cause both of epoc and lung cancer and, according to the National Health Survey of 2017, 18.8% of women and 25.6% of men smoke daily and 2.0% of women and 2.7% of men declare themselves occasional smokers.
People with epoc present an increase in associated chronic diseases, caused by smoking, advanced age and other risk factors, among which are ischemic heart disease, psychological disorders (anxiety and depression), heart failure, arrhythmias, high blood pressure, pulmonary hypertension, sleep apnea or lung cancer.
Given that COPD is a chronic and progressive disease, its detection in early stages, together with the cessation of smoking, may lead to a better prognosis, for which the SCS considers a active search in primary care consultation by asking the patient questions about cigarette consumption and chronic respiratory symptoms in smokers.
Likewise, its approach is also carried out through the General Directorate of Public Health, through the projects of healthy habits and the Program of help to the smoker in the Canary Islands (Pafcan), which complements with pharmacological, medical and psychological tools, continued from Health, which already attended this year to 7,627 people with the anti-tobacco plan.
The clinical diagnosis of suspected epoc It must be considered in those over 40 years, with a history of smoking, both current and past, equivalent to smoking 20 cigarettes a day for 10 years and with respiratory symptoms such as dyspnea, cough and expectoration or intolerance to physical exercise.
Given this suspicion, a spirometry, which is the test that measures lung function to determine if a person has epoc and can detect it even in people who do not yet have symptoms.
The SCS, through the primary care managements of the seven islands, has spirometers in all the health centers so that, from the consultations of family medicine, this test can be requested in case of clinical suspicion of COPD or for monitoring of other respiratory pathologies.
In this sense, a major effort is being made to renew the spirometry park by means of a Public tender for the acquisition of 82 appliances for the centers that are dependent on the primary care managers and health service managers of the SCS, which is in the process of being awarded.
Both the Strategy of approach to chronicity in the Autonomous Community of the Canary Islands, of 2015, as the Canary Islands Health Plan 2016-2017 propose the development of integrated care processes and routes as key initiatives through the development of patient-centered care, including epoc as one of the priority pathologies of action.