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COPD in Asia^*

Where East Meets West

^* From the iCapture Center for Cardiovascular and Pulmonary Research (Dr. Tan), St. Paul’s Hospital, Vancouver, BC, Canada; and the Gerontological Research Programme (Dr. Ng), National University of Singapore, Singapore.

Correspondence to: Wan C. Tan, MD, FCCP, University of British Columbia, iCapture Center for Cardiovascular and Pulmonary Research, St Paul’s Hospital, 1081 Burrard St, Vancouver, BC, V6Z 1Y6 Canada; e mail: wtan{at}mrl.ubc.ca

Abstract

COPD is a global health concern, and is a major cause of chronic morbidity and mortality worldwide. According to the World Health Organization, it is currently the sixth leading cause of death in the world, and further increases in the prevalence and mortality of the disease is predicted for the coming decades. These increases are mainly linked to the epidemic of tobacco exposure and indoor and outdoor air pollution in Asian countries. The burden of COPD in Asia is currently greater than that in developed Western countries, both in terms of the total number of deaths and the burden of disease, as measured in years of life lost and years spent living with disability. The types of health-care policies and the practice of medicine vary considerably among the regions of Asia and have an impact on the burden of disease. Treatment aims in Asian countries are based on evidence-based management guidelines. Barriers to the implementation of disease management guidelines are related to issues of resource conflict and lack of organizational support rather than cultural differences in medical practice. To reduce this burden of COPD in Asian countries, there is a need for a multifaceted approach in improving awareness of prevalence and disease burden, in facilitating accurate diagnosis of COPD among chronic respiratory diseases, in championing health policies that reduce the burden of the main risk factors for COPD and in the wider use of evidence-based management for COPD.

Key Words: bronchodilators • COPD • pulmonary epidemiology • pulmonary rehabilitation • smoking