The National Lung Health Education Program and Managed Care: The Importance of Early Identification and Intervention in Chronic Obstructive Pulmonary Disease
Thomas L. Petty
The National Lung Health Education Program (NLHEP) is a new healthcare initiative which encourages the early diagnosis of and intervention in patients who are in the process of developing chronic obstructive pulmonary disease (COPD) and related disorders. COPD is primarily a smoker's disease. Lung injury is due to proteolytic and oxidative damage early in the course of disease and results in premature loss of lung function, as measured by forced expiratory volume in 1 second (FEV1). Smoking cessation will retard this rate of decline and improve prognosis. The most common cause of death in patients with early stage COPD is lung cancer. Thus, the possibility of lung cancer should be investigated in patients with early degrees of airflow obstruction. The NLHEP Spirometry Statement encourages testing of all smokers aged over 45 years, and anyone with cough, dyspnea, mucus hypersecretion, or wheeze. The spirometry industry has responded to the NLHEP by developing simple, accurate, reliable, and inexpensive office spirometers for screening purposes. It is hoped that the widespread use of spirometry will begin to reduce the socioeconomic impact of COPD and related lung cancer. Managed care should endorse the goals and objectives of the NLHEP for the benefit of their patients, and to help contain costs.
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