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My conflicts of interest during the last two years

My conflicts of interest during the last two years. GSK has supported my participation in ERS congress 2010. Best Practice Finland: COPD Action Programme – 10 year results. Anne Pietinalho, Ass. Prof., Dr, FCCP Chief physician, Raasepori Health Care center

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My conflicts of interest during the last two years

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  1. My conflicts of interest during the last two years • GSK has supported my participation in ERS congress 2010 Utrecht, September the 23th 2011

  2. Best Practice Finland: COPD Action Programme – 10 year results Anne Pietinalho, Ass. Prof., Dr, FCCP Chief physician, Raasepori Health Care center and a specialist in Filha (Finnish Lung Health Association) Utrecht, September the 23th 2011

  3. Backgrounds and goals Utrecht, September the 23th 2011

  4. Population: 5.2 million inhabitants Smokers: > 1 million COPD: 200 000 patients Tobacco Legislation : 1977 - Ban on advertising 1995 - Ban on smoking in public places and at work 4 important authorities on the respiratory field gave a proposal to the Ministry of Social Afairs and Health in 1996 COPD Program 1998–2007 Key points and figures at the start of the program Utrecht, September the 23th 2011

  5. Goals of prevention and treatment 1. To decrease the incidence of chronicbronchitis. 2. To achieverecovery of as manychronicbronchitispatients as possible. 3. COPD patientsfeelwell, and theircapacity for work and functionremains good. 4. To decrease the proportion of severe and moderate COPD. 5. To decrease the number of bed-days of COPD patientsby 25%. 6. To decrease the annualcosts per patient. Utrecht, September the 23th 2011

  6. Implementation – to whom, how, what and how much? • Information for • all health care workers & • population • Multidiciplinary education/trainingin • good collaboration together with Filha, specialized health care, occupational health care and primary health care but also private doctors and nurses were invited • training events • publications • internet based information • Training consisted of presentations concerning • COPD as a disease, diagnosis (spirometry), treatment , smoking cessation and rehabilitation • Totally • 900 events • for 25 000 health care workers Utrecht, September the 23th 2011

  7. What else was ongoing during the time of the program? • AsthmaProgram 1994-2004 • EB guidelines • 1999 for COPD • 2000 for asthma • 2002 for smoking cessation • 2006 for NonInvasiveVentilation • Changes in the healthcareorganization • fewerhospitalplaces • moreoutpatientbasedtreatment • Strongertobaccolegislation • 2003 - tobaccosmokecarcinogenic • 2007 - ban on smoking in restaurants Utrecht, September the 23th 2011

  8. Results(Kinnula V et alPrim Care Resp J 2011;20(2):178-183) Utrecht, September the 23th 2011

  9. Knowledges, skills and resources • Health care personnel has • improved knowledges and skills on COPD • improved attitudes towards smokers and COPD patients • Population has now better knowledge on COPD • Primary health care has improved • resources: 700 asthma nurses in primary health care take also care of COPD and smoking cessation • tools: PEF-meters and spirometry equipments in all healt care stations • Pharmacies have • 700 asthma contact persons taking care of COPD and smoking cessation as well Utrecht, September the 23th 2011

  10. COPD prevalenceamong the adultshasnotrisen • 1978-1980: males 4.7%, females 2.2% • 2000-2001: males 4.3 %, females 3.1% Vasankari TM et al. ERJ 2010 Utrecht, September the 23th 2011

  11. Quality of spirometry in the health care – use of recommended reference values and calibration of the equipments Utrecht, September the 23th 2011

  12. Hospital days due to COPD in 1997–2007 Number/100 000 Hospital days per 100 000 Men 35-64 years National Institute for Health and Welfare Utrecht, September the 23th 2011

  13. Smoking among adults in Finland p<0.001 Y 2010 M 23% F 16% National Institute for Health and Welfare Utrecht, September the 23th 2011

  14. Retirementsdue to COPD Retirementsdue to all Social Insurance Institution Utrecht, September the 23th 2011

  15. Mortalitydue to COPD Statistic Finland Utrecht, September the 23th 2011

  16. Costs due to COPD in Finland milj eur 88% Medicines + Hosp.treat.+ Out patient Tynkkynen et al 2009 Utrecht, September the 23th 2011

  17. Costs due to COPD in Finland milj eur 88% Medicines + Hosp.treat.+ Out patient Tynkkynen et al 2009 Utrecht, September the 23th 2011

  18. Conclusions • The implementation was a hard work but anyhow: • COPD is now a relatively well known disease among the population • The attitudes, knowledge and skills for COPD, spirometry and smoking cessation among health care personnel have improved and the resources have increased • The Program in combination with many other efforts had several positive consequences: • stopping increase of COPD prevalence • reduction of smoking • improving quality of diagnosis • reduction of hospitalisations and costs for COPD • stopping increase of COPD costs Utrecht, September the 23th 2011

  19. Thank you for your attention! Utrecht, September the 23th 2011

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