The national lung health education program and managed care - The importance of early identification and intervention in chronic obstructive pulmonary disease

The National Lung Health Education Program (NLHEP) is a new healthcare init iative 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 i njury is due to proteolytic and oxidative damage early in the course of dis ease and results in premature loss of lung function, as measured by forced expiratory volume in 1 second (FEV1). Smoking cessation will retard this ra te of decline and improve prognosis. The most common cause of death in patients with early stage COPD is lung ca ncer. Thus, the possibility of lung cancer should be investigated in patien ts with early degrees of airflow obstruction. The NLHEP Spirometry Statemen t encourages testing of all smokers aged over 45 years, and anyone with cou gh, dyspnea, mucus hypersecretion, or wheeze. The spirometry industry has r esponded to the NLHEP by developing simple, accurate, reliable, and inexpen sive office spirometers for screening purposes. It is hoped that the widesp read use of spirometry will begin to reduce the socioeconomic impact of COP D and related lung cancer. Managed care should endorse the goals and object ives of the NLHEP for the benefit of their patients. and to help contain co sts. The objective of this article is to describe the goals and objectives of th e National Lung Health Education Program, a new national healthcare initiat ive which encourages the early diagnosis of chronic obstructive pulmonary d isease (COPD) and related disorders by the widespread use of spirometers in patients at risk.