Congressional Caucus Champions COPD Issues

Vol. 17 •Issue 16 • Page 17
Congressional Caucus Champions COPD Issues

COPDers have some new champions on Capitol Hill in the shape of a group of legislators eager to spread information about the disease. On July 12, U.S. Sen. Mike Crapo (R-Idaho) announced the formation of a Congressional Chronic Obstructive Pulmonary Disease Caucus.

“COPD is a major national health problem,” said Crapo. “It is estimated that over 13 million people in the U.S. have been diagnosed with some form of COPD, with millions more undiagnosed. The disease accounts for 8 million office visits and more than 1.5 million emergency room visits every year, and costs over $32 billion dollars in medical expenditures and lost work hours. The Congressional COPD Caucus is a necessary first step to address an important problem.”

The caucus will address the problem by furthering awareness of COPD risks and promoting policies that improve the lives of COPD patients. Crapo will chair the caucus and plans on partnering with a broad coalition of physician, patient and homecare organizations to educate members of Congress about COPD. They will also advocate policies to encourage prevention and early detection.

Caucus members include: Reps. John Lewis (D-Ga.) and Cliff Stearns (R-Fla.) as co-chairs. Partner organizations include: the American College of Chest Physicians (ACCP), the American Association for Homecare, Alpha-1 Association, American Thoracic Society, American Lung Association and the American Association for Respiratory Care.

COPD is only one of Crapo’s health care causes. In fact, he has become well known as a health care activist since his January 2000 diagnosis and successful treatment of prostate cancer. For the past three years, Crapo has sponsored Health Awareness Booths for prostate and breast cancer screening and with cholesterol and blood pressure checks at regional fairs in Idaho. He co-chairs the Congressional Heart and Stroke Coalition.

COPD Awareness Day

The COPD Coalition should be recognized for its efforts in garnering Congressional support for COPD. The group is leading the way to publicize COPD Awareness day activites slated for Nov. 17.

The coalition Web site is The coalition is a strong supporter of the Globall Initiative for Chronic Obstructive Lung Disease (GOLD). This international group has been very busy too.

The GOLD Executive Committee met in London on Jan. 30-31 to discuss the Gold project, now in its fifth phase. The primary goals for GOLD are to increase awareness of COPD as an illness in both the professional and public sectors; recommend effective management and prevention strategies; decrease morbidity and mortality through diagnosis and management programs; encourage research in COPD; and monitor the published literature about COPD.

The group charged with the most work is the GOLD scientific Committee. In fact, that panel took up a good part of the agenda for the January meeting. The committee presented a report on the current literature and their recommendations for the 2004 update of the GOLD Workshop Report.

Topics the committee believes need further consideration are: step up/step down therapy, surgery in COPD and walking aids. Committee members were assigned to prepare reports on these topics and present their findings to the committee.

The updated recommendations are to be posted on the GOLD Web site this month. But as of this printing, the regulations are not online. Use of antibiotics for COPD will be reviewed as a topic in 2005. In fact, a revision of the entire GOLD workshop report is scheduled for in 2005 and will be published in 2007. The revision will incorporate the most recent literature.

International Efforts

The committee is taking great pains to make its new report as comprehensive and inclusive as possible. One of the publications they will be reviewing closely is the American Thoracic Society/ European Respiratory Society recommendations.

Committee members noted that while their document and the ATS/ERS document were similar, the ATS/ERS document included the phrase that “COPD is a treatable and preventable disease” in its definition. Currently the GOLD definition does not include this distinction, although GOLD leaders are considering adding it.

Why all this fuss you may ask. It is probably more than just the scientific pursuit of linguistic excellence. If COPD is not defined as treatable and/or preventable, then professional health care organizations working toward improving COPD outcomes or research may well be excluded from some funding opportunities.

In the public health sector, the phrasing may also have political ramifications. Third-World governments with limited resources may be more likely to commit services to a preventable disease than to a non-preventable one, so the terminology makes a difference.

In fact, since the initial publication of the GOLD Report, there have been substantial advancements in the reporting of COPD in Third-World countries. It is anticipated that the Burden of COPD (Chapter 2 in the original report) will be greatly expanded. This will likely increase awareness and perhaps pressure the Third-World nations on the management and care of COPD.

Earlier Actions

The GOLD Dissemination Committee also took center stage at the January meeting. That panel is actively working with groups around the world to promote COPD awareness day. The theme will be the same as last year’s “Raising Awareness.” Sponsors hope countries will incorporate the “it is treatable and preventable” themes into their activities.

The GOLD Executive Committee is also entertaining the idea of a Global Airways Disease Initiative. This project would coordinate the global efforts of three projects: the Global Initiative for Asthma (GINA), Global Initiative for Chronic Obstructive Lung Disease (GOLD) and Allergic Rhinitis and Impact on Asthma (ARIA). This idea is in the early talking stages and great deal more information is needed.

It has become increasingly clear that COPD is a world wide concern. The U.S. is taking an active stance against the disease.

“The creation of the Congressional COPD Caucus marks a significant victory in the campaign to expand awareness of a quiet killer,” noted John W. Walsh, president and CEO of the Alpha-1 Foundation.

Others also lined up to praise the action of Washington legislators.

“On behalf of the American Thoracic Society, I congratulate Sen. Crapo and Reps. John Lewis and Cliff Stearns for starting the Congressional COPD Caucus,” said Homer A. Boushey Jr., MD, president of the ATS.

Another powerful group spoke out in favor of the caucus creation. “For years, the ACCP has recognized the severe impact COPD has on the lives of our adult patients, their families, and the national health system; however, to the general public, it is nearly an unrecognized disease,” said Richard S. Irwin, MD, FCCP, president of the American College of Chest Physicians.

Margaret Clark is a Georgia practitioner.