| Autor: |
Polverino F; Section of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Baylor College of Medicine, Houston, Texas., Bhutani M; Division of Pulmonary Medicine, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada., Zabert G; Clínica Pasteur, Universidad Nacional de Comahue, Neuquen, Argentina., Fernandes FLA; Disciplina de Pneumologia, Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil., Czischke K; Departmento de Medicina Pulmonar, Clínica Alemana de Santiago, Universidad del Desarrollo, Santiago, Chile., Pereira Ferreira LF; Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil., Szabo L; Department of Medicine, University of Calgary, Calgary, Alberta, Canada., Wisnivesky JP; Division of General Internal Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York., Dalcolmo MP; Centro de Referência Helio Fraga, Fundação Oswaldo Cruz, Fiocruz, Rio de Janeiro, Brazil; and., Celedón JC; Division of Pediatric Pulmonary Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. |
| Abstrakt: |
Chronic obstructive pulmonary disease (COPD) is a major public health problem in the Americas (a region of the world comprising North, Central, and South America), although there is substantial variation in disease prevalence, morbidity, and mortality between and within nations. Across the Americas, COPD disproportionately affects vulnerable populations, including minoritized populations and impoverished persons, who are more likely to be exposed to risk factors such as tobacco use, air pollution, infections such as tuberculosis, and biomass smoke, but less likely to have adequate healthcare access. Management of COPD can be challenging across the Americas, with some barriers being specific to certain countries and others shared across the United States, Canada, and Latin America. Because most cases of COPD are undiagnosed because of suboptimal access to health care and pulmonary function testing and, thus, cannot be treated, increased access to spirometry would have a substantial impact on disease management across the Americas. For individuals who are diagnosed, access to medications and other interventions is quite variable across and within nations, even in those with universal healthcare systems, such as Canada and Brazil. This emphasizes the importance of collaborative treatment guidelines, which should be adapted for the healthcare systems and policies of each nation or region, as appropriate. To have a positive impact on COPD management in the Americas, we propose actionable items, including the need for all our respiratory societies to engage key stakeholders (e.g., patient-led organizations, professional societies, and governmental and nongovernmental agencies) while advocating for campaigns and policies to ensure clean air for all; eliminate tobacco use and enhance coverage for treatment of nicotine dependence; and improve access to early case finding, diagnosis, and treatment for all patients, including underserved and vulnerable populations. |
