Overview
Sponsored by the American College of Chest Physicians.
Supported by an unrestricted educational grant from GlaxoSmithKline.
Program Description
COPD is often misdiagnosed, and people with COPD are commonly treated for asthma. Primary care physicians indicate that they prescribe similar medications for COPD and asthma, even though the appropriate treatments differ. First-line maintenance therapy for most patients with asthma is an inhaled corticosteroid, with the addition of bronchodilators, if needed, to control symptoms. However, bronchodilators are the first-line maintenance treatment for COPD. Treatment with inhaled corticosteroids is reserved only for patients with COPD that is not adequately managed with bronchodilators. This session will address common clinical problems seen in today’s practice; the overlap between asthma and COPD; and the pathophysiologic, diagnostic, and management similarities and differences between these disorders.
In this web-based format, participants have the opportunity to obtain the information as it was originally presented by watching the video slide presentations on line, downloading the slides for review, or downloading a written executive summary of the presentations to read. Following their review of the presentations, participants will be asked relevant test questions as part of the evaluation process to obtain CME credit.
Educational Objectives
- Outline the similarities and differences in the pathophysiologic mechanisms between asthma and COPD.
- Examine the similarities and differences in the clinical presentation of asthma and COPD.
- Review the similarities and differences in the pharmacologic management of asthma and COPD.
- Outline the similarities and differences in novel targets for therapy for asthma and COPD.
Target Audience
Advanced Practice Nurses, Cardiologists, Critical Care Physicians, Fellows-in-Training, General Medicine Physicians, Physician Assistants, Pulmonary Physicians, Registered Nurses, and Respiratory Therapists.
Needs Assessment
COPD is a major health problem in the United States. More than 12 million people have been diagnosed with COPD, and another 12 million have signs of the disease but have not yet been diagnosed.1 It is the fourth leading cause of death in America, with 119,000 deaths annually.2 Asthma is also a common disease in the age group that is at risk for COPD, with 6.5 to 8.7% of older adults reporting that they have been told by a doctor that they have asthma.3
The diagnosis of asthma and COPD can be problematic. People with COPD are commonly misdiagnosed and instead treated for asthma. In some instances, this may be due to the lack of measurement of postbronchodilator FEV1 in the diagnosis.4 Moreover, there may be some degree of reversibility in patients with COPD and fixed obstruction in patients who are asthmatic.
The first-line maintenance therapy for most patients with asthma is an inhaled corticosteroid with the addition of bronchodilators, if needed, to control symptoms. However, the reverse is true for the treatment of COPD. This activity addresses common clinical problems seen in practice and the overlap between asthma and COPD. It discusses pathophysiologic, diagnostic, and management similarities and differences between these disorders.
COPD and asthma are important to the members of the ACCP, as most members treat these diseases every day. The ACCP has included COPD and asthma in the core curriculum that is being developed to guide the ACCP in its educational offerings. Moreover, the ACCP CHEST 2008 Program Committee named COPD and asthma as two of the key topics to be covered at the CHEST 2008 annual meeting.
References
- 1. National Heart, Lung, and Blood Institute. COPD: Learn More, Breathe Better. Learn About COPD.org. Accessed April 10, 2009
- 2. National Center for Health Statistics. National vital statistics reports—deaths: preliminary data for 2004.
- 3. Pleis JR, Lethbridge-Çejku M. Summary health statistics for U.S. adults: national health interview survey, 2005. Vital Health Stat 2006; 232:1-153
- 4. Enright P, Quanjer P. Spirometry for COPD is both underutilized and overutilized. Chest 2007; 132:368-370
Faculty
Nicholas J. Gross, MBBCh, FCCP
Volunteer Attending Physician
Hines VA Hospital
Hines, IL
Emeritus Professor
Department of Medicine
Department of Molecular Biochemistry
Stritch-Loyola School of Medicine
Maywood, IL
Mario Cazzola, MD, FCCP
Professor of Respiratory Medicine
University of Rome Tor Vergata
Department of Internal Medicine
Rome, Italy
James F. Donohue, MD, FCCP
Professor of Medicine
Chief, Division of Pulmonary and Critical Care Medicine
University of North Carolina School of Medicine
Chapel Hill, NC
CME & Disclaimers
Release: May 2009
CME Expiration: June 30, 2010
Estimated completion time: 2 hours
This CME product is a Web-based activity.
Participants will watch and listen to a Webcast slide presentation and complete an activity evaluation to obtain CME.
Accreditation/Designation
The American College of Chest Physicians is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The American College of Chest Physicians designates this educational activity for a maximum of 2 AMA PRA Category 1 CreditsTM. Physicians should only claim credit commensurate with the extent of their participation in the activity.
Anyone who attended the Asthma and COPD: Similarities and Differences morning symposium session at CHEST 2008 when this content was originally presented, and already claimed CME for this presentation, cannot claim CME from this enduring product.
Disclosure Statement
The ACCP remains strongly committed to providing the best available evidence-based clinical information to participants of this educational activity and requires an open disclosure of any potential conflict of interest identified by our faculty members. It is not the intent of the ACCP to eliminate all situations of potential conflict of interest, but rather to enable those who are working with the ACCP to recognize situations that may be subject to question by others. All disclosed conflicts of interest are reviewed by the educational activity course director/chair, the Education Committee, or the Conflict of Interest Review Committee to ensure that such situations are properly evaluated and, if necessary, resolved. The ACCP educational standards pertaining to conflict of interest are intended to maintain the professional autonomy of the clinical experts inherent in promoting a balanced presentation of science. Through our review process, all ACCP CME activities are ensured of independent, objective, scientifically balanced presentations of information. Disclosure of any or no relationships will be made available on-site during all educational activities.
The following faculty members of this educational activity have disclosed to the ACCP that a relationship does exist with the respective company/organization as it relates to their presentation of material and should be communicated to the participants of this educational activity:
Mario Cazzola, MD, FCCP
Grant monies (from industry related sources): Travel grants from Boehringer Ingelheim, Novartis, AstraZeneca, and Menarini
Fiduciary position (of any organization, association, society, etc, other than the ACCP: At the present time, Secretary, Inflammatory Airways Diseases and Clinical Allergy Assembly. From October 2008, Director of Postgraduate Courses at the European Respiratory Society, Scientific Bureau of Società Italiana di Medicina Respiratoria
Consultant fee, speaker bureau, advisory committee, etc: Advisory committee: Nycomed (Altana), GSK, Novartis, and Dey; speaker bureau: Novartis
Product/procedure/technique that is considered research and is NOT yet approved for any purpose: Drugs to be used in the treatment of COPD that are still in development
Nicholas J. Gross, MBBCh, FCCP
University grant monies: AstraZeneca, Forest
Grant monies (from industry related sources): Dey, L.P, Boehringer Ingelheim, AstraZeneca, ALTANA
Consultant fee, speaker bureau, advisory committee, etc: (1) Consultant fee: Dey, L.P., GSK, Almirall, ALTANA. (2) Speaker bureau: Boehringer Ingelheim, Dey, L.P., AstraZeneca. (3) Advisory committee: Dey, L.P., GSK
James F. Donohue, MD, FCCP
University grant monies: BI, Pfizer, Almiral, and I have grants with University of North Carolina where I am PI
Grant monies (from sources other than industry): NIH, Alpha-1 Antitrypsin Foundation
Grant monies (from industry related sources): Industry grants are to University of North Carolina
Consultant fee, speaker bureau, advisory committee, etc: (1) Advisory committee: (US) GSK, BI, Pfizer, Novartis, Sepracor, Astra-Zeneca, Therevance, Asubio, Biomarck, Forest LABS, Global; Almiral, Chiesi, Novartis. (2) Speaker bureau: GSK, AZ, BI, Pfizer. (3) DSMB; Schering-Plough, Sepracor, Novartis, Lilly
Disclaimer
The American College of Chest Physicians ("ACCP") and its officers, regents, executive committee members, members, related entities, employees, representatives and other agents (collectively, "ACCP Parties") are not responsible in any capacity for, do not warrant and expressly disclaim all liability for, any content whatsoever in any ACCP publication or other product (in any medium) and the use or reliance on any such content, all such responsibility being solely that of the authors or the advertisers, as the case may be. By way of example, without limiting the foregoing, this disclaimer of liability applies to the accuracy, completeness, effectiveness, quality, appearance, ideas, or products, as the case may be, of or resulting from any statements, references, articles, positions, claimed diagnosis, claimed possible treatments, services, or advertising, express or implied, contained in any ACCP publication or other product. Furthermore, the content should not be considered medical advice and is not intended to replace consultation with a qualified medical professional. Under no circumstances, including negligence, shall any of the ACCP Parties be liable for any DIRECT, INDIRECT, INCIDENTAL, SPECIAL or CONSEQUENTIAL DAMAGES, or LOST PROFITS that result from any of the foregoing, regardless of legal theory and whether or not claimant was advised of the possibility of such damages.
CME Instructions
CME for this activity is available through June 30, 2010. To receive CME credit and print your certificate, complete an online evaluation by doing the following:
- Go to www.chestnet.org, and click on the "CME Certificates" icon.
- Log in using your ACCP ID number or e-mail address on file with the ACCP. Enter your ACCP ID number and click submit, OR, if you do not have an ACCP ID number, click on the link, "Create an account here."
- To locate the product for which you want to claim CME credit, look under the "Available CME" tab on the left navigation bar.
- Click the "Claim Credit" link next to the product to begin the certificate process.
- Complete any required posttest and evaluation. Please be sure to check the box that states you are finished with the evaluation.
- Once you submit the evaluation, your CME certificate will be created and will show under the tab, "My CME History." You can print it at any time by clicking the "Certificate" link.
If you need help, please contact the CME Administrator via e-mail at CME@chestnet.org, or leave a voice mail message at (847) 498-8376. For faster assistance, please outline the specific problem you are having, and provide your ACCP ID and contact information.
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