Elevating COPD Management: Enhancing Treatment and Improving Patient Outcomes - Episode 11
Addressing Barriers to COPD Treatment Escalation and the Importance of Continuity of Care
Panelists discuss common barriers to timely escalation of chronic obstructive pulmonary disease (COPD) treatment, including infrequent follow-up visits, fragmented care across multiple providers, and delayed communication of exacerbations or hospitalizations, as well as therapeutic inertia stemming from competing clinical priorities and insufficient patient education; they emphasize the need for integrated, proactive strategies such as shared electronic medical records, rapid posthospitalization follow-up, care coordination, and enhanced patient engagement to overcome these challenges and optimize treatment adjustments.
One of the most common barriers to timely escalation of COPD treatment is the infrequency of patient follow-up visits. Many patients are seen every 3 to 6 months, or even annually if considered stable, which can delay recognition of worsening symptoms or exacerbations. Additionally, patients often receive care from multiple providers and health systems, leading to fragmented communication. Hospitalizations or emergency visits may not be promptly communicated back to the primary COPD specialist, and patients themselves may not always report these events. This lack of timely information creates challenges in adjusting treatment plans effectively and quickly.
Therapeutic inertia also plays a significant role in delayed treatment escalation. Clinicians may continue with familiar management approaches and may not reassess or intensify therapy promptly, especially during busy clinic visits where many competing priorities exist. Patient education can sometimes be insufficient, and many patients lack clear action plans for managing exacerbations or understanding when to seek care. Without frequent monitoring or active engagement, worsening symptoms and risks can be missed, prolonging suboptimal control and increasing the chance of future exacerbations.
To overcome these barriers, a more integrated and proactive approach is necessary. This includes improving communication between specialists, primary care providers, hospitalists, and emergency departments through shared electronic medical records and coordinated care pathways. Implementing rapid posthospitalization follow-up clinics and using dedicated care coordinators or COPD navigators can help ensure patients receive timely reassessment and support. Encouraging patient education about exacerbation management and the importance of informing their care team about hospital visits is also crucial. Together, these strategies can help reduce delays in therapy escalation, improve symptom control, and ultimately decrease exacerbation frequency and severity.
