Comprehensive Treatment: It’s All About Breathing

Coughing, airway obstruction, difficulty breathing: Chronic obstructive pulmonary disease (COPD) is an umbrella term used to describe progressive and currently incurable lung diseases. The innovative solutions of Philips Respironics help patients to manage each stage of the disease and their medication intake, train the respiratory system and provide respiratory support.

In this MEDICA-tradefair.com interview, Philipp Weber talks about treatment options, discusses the role of digital support services and explains how crucial it is for the patient’s health to maintain autonomy and social participation.

COPD disease progression can be classified into different stages. How do they differ?

Philipp Weber: COPD is broken down into the GOLD stages I to IV. The most important criteria for the distinction are forced expiratory volume in one second (FEV1) and forced vital capacity (FVC). A pulmonary function test is performed to measure these values. A FEV1/FVC ratio that is less than 70% indicates the possibility of COPD. There is also an additional relatively new ABCD grading system, which gives an initial recommendation for medications to treat the disease. The criteria in this setting are the number and severity of exacerbations and the test results of the Modified Medical Research Council (CMRC) dyspnea questionnaire and the CAT (COPD Assessment Test) score.

How do your devices help patients to manage their COPD treatment?

Weber: Due to the progressive damage to their lungs, patients with COPD increasingly experience low blood oxygen levels. Our products include nebulizers and inhalers, oxygen concentrators, and respiratory therapy solutions that help patients to absorb adequate amounts of vital oxygen (Philips in the exhibitor catalogue at MEDICA). COPD therapy always includes multiple pillars. It is essential that the drugs reach their destination in the right concentration. Nebulizers like the Philips InnoSpire Go convert the active ingredient to aerosol at a particle size between 1 and 5 μm, allowing it to reach deep into the lower airway tract. We offer oxygen concentrator solutions for home or portable use. They purify ambient air with just under 21 percent oxygen content, remove nitrogen and other components from it and subsequently deliver up to 96 percent pure oxygen to the patient. This is done in either continuous flow or pulse flow mode. Continuous flow mode provides a constant flow of oxygen per minute. Pulse flow mode is the preferred setting in portable devices and delivers oxygen every time the patient takes a breath. This extends the device’s battery life and ensures longer runtime. At the severe stage, non-invasive and invasive ventilator devices help patients to breathe easier or assume the breathing function for them.

The Personal Best Peak Flow Meter is a device that helps patients with lung diseases like asthma to monitor their own peak flow rate. How does this work for COPD?

Weber: As with other respiratory diseases, it is also difficult to predict acute exacerbation in COPD, i.e., a sudden worsening of symptoms that affects the patient’s wellbeing and lasts more than 24 hours. Oftentimes, patients do not fully recover from this type of event. The FEV1 value is an important indicator of an imminent exacerbation and can be measured by using the Peak Flow Meter. Based on a color-coded three-zone traffic light system (green, yellow and red) and regular daily application, patients can see by the readings whether their condition is worsening. If that’s the case, they should consult a physician immediately.

How important is it to train and strengthen the breathing muscles and what kind of medical devices can provide support?

Weber: It is very important for COPD patients to train their respiratory muscles to the best of their abilities. Devices like the Threshold IMT Inspiratory Muscle Trainer can help patients to accomplish this task. In this case, the device provides resistance when the patient inhales, which strengthens the respiratory muscles. This method is not just used in the medical realm, but is also applied in professional sports to improve an athlete’s performance. Having said that, the primary objective for COPD patients is to maintain the status quo, which is crucial to improve the quality of life for patients suffering from this currently incurable disease. However, before patients embark on an exercise routine, they must first consult with their treating physician, who gives the green light and approves any regimen.

What role do digital support services play in COPD treatment today?

Weber: Digital solutions can make a significant contribution to improving COPD treatment. For example, take a project that was launched in March 2018 and is funded by the German Federal Ministry of Education and Research (BMBF) titled “Digitales Therapieunterstützungssystem in der außerklinischen Beatmung bei COPD-Patienten” or DIGIVENT (English: digital outpatient ventilation support system for COPD patients). Coordinated by Philips GmbH Innovative Technologies Aachen, the Clinic for Pneumology and Internal Intensive Care Medicine at the University Hospital RWTH Aachen, the Department of Computer Science of the Dortmund University of Applied Sciences and Arts and KAIROS GmbH jointly study whether the administration and monitoring of non-invasive ventilation (NIV) in COPD patients can be performed by medical staff outside the hospital under the supervision of a telemedicine physician in the future. NIV is a treatment option for some patients in the severe stage of COPD that is not only able to improve the quality of life but also promotes long-term survival. In light of an increasing number of patients and simultaneous skilled labor shortage, the aim is to counteract a projected health care shortage in the future.

From your perspective, how important are medical technology advances for COPD treatment?

Weber: Advances in medical technology can help to significantly improve or at least maintain the quality of life in COPD patients. However, for patients with chronic conditions, quality of life means far more than simply improving or stabilizing their physical health and wellbeing. Autonomy and social participation are equally important and decisive factors that affect the patient’s mental health.