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November 15th is World COPD Day

November 15th is World COPD Day. The INSPIRED COPD Outreach team is pleased to update you about our program and to introduce projects underway to improve access and care across the COPD continuum.

As you know, COPD is a major contributor to hospital admissions, emergency visits and mortality. Globally, COPD is one of the top 3 causes of mortality.  In Nova Scotia, prevalence is 13%, higher than the national average of 10%. COPD is the second leading cause of hospitalization in NS, with direct costs of $23M in 2019-2020.  

INSPIRED (Implementing a Novel and Supportive Program of Individualized care for patients and families living with Respiratory Disease) was developed in 2010 to address gaps in care leading to unnecessary ED visits and hospital admissions for exacerbations of COPD, and to empower patients to better understand and self-manage their disease.

From 2011 - 2018 INSPIRED expanded from CZ (Halifax, Dartmouth, Eastern Shore, Hants, Cobequid) to the EZ (Sydney), WZ (Bridgewater) and NZ (Amherst). In 2021 an INSPIRED team began providing service in Truro from our original funding. In 2021 (as per NSH Data Analytics team’s assessment) the INSPIRED Program continued to demonstrate significant reductions in health care utilization at 6 months post enrollment. This supported expansion of our program to the rest of the province: Yarmouth and Kentville (WZ), New Glasgow, Antigonish and Inverness (EZ). We continue to strive to provide equitable access and welcome referrals to our INSPIRED COPD Outreach program.

With support from Research Innovation and Discovery, in 2022 INSPIRED embarked on a project to address access to spirometry at the community level, starting in the Musquodoboit Valley - Eastern Shore area. Implementing this COPD Care and Education NS program required a fee code amendment to permit spirometry test interpretation to be remunerated when performed outside of health care facilities (MSI bulletin July 21, 2023), development of portable droplet containing booths (Catalyst Grant), leveraging advances in technology that support remote interpretation, and the creation of a virtual education program for mild to moderate COPD.

A second innovation followed when INSPIRED partnered with the Cobequid PWiC+ clinic to support the referral, diagnosis and management of unattached patients suspected of having COPD. The goal is to ‘scale and spread’ this initiative to other zones, improving how we support people suspected of having COPD and improve health outcomes through timely diagnosis and the use of Canadian Thoracic Society guided management.

End stage COPD, like other chronic non-cancer illnesses such as Heart Failure, is under supported by Palliative Care services due to human resource limitations. In Central Zone, two skilled Nurse Practitioners, Lesley MacGregor and Amanda Tinning, have developed ‘The Home Breathlessness Team’ to support a Palliative Approach to Care for severely frail individuals with dyspnea due to end stage COPD/Heart Failure.

INSPIRED works collaboratively with our physician colleagues and community partners to provide Nova Scotians with COPD effective care. In keeping with this year’s World Lung Health theme, INSPIRED strives for “Access to prevention and treatment for all – leave no one behind”. 

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