GSK Partners with Multiple Stakeholders at the 5th CIIE to Advance COPD Prevention and Management System

ShanghaiNovember 7, 2022PR Newswire -- GSK successfully held the event "Unite and Breathe Freely" at the Fifth China International Import Expo. Ms. Kong Lingzhi, Standing Vice President and Secretary General of the Chinese Health Promotion and Education Association, Professor Yang Ting, Director of the Clinical Diagnosis Department of the Respiratory Center at China-Japan Friendship Hospital, Professor Chen Rongchang, Director of the Respiratory Disease Research Institute at Shenzhen People's Hospital, Professor Song Yuanlin, Director of the Department of Pulmonary and Critical Care Medicine at Zhongshan Hospital affiliated to Fudan University, and Professor Zhu Huili from the Department of Pulmonary and Critical Care Medicine at East China Hospital affiliated to Fudan University attended the event. Through keynote speeches and roundtable discussions, they engaged in enthusiastic discussions. The event summarized the significant achievements of the "Happy Breathing" project over the past five years in promoting the implementation of national COPD hierarchical diagnosis and treatment policies, showcased decades of reliable medical evidence-based research and exploration into COPD prevention and treatment in China, emphasized the dangers of COPD exacerbations and non-standard medication use, shared extensive experiences in promoting early diagnosis and treatment across all levels of medical institutions nationwide, and launched the 2022 GSK COPD Awareness Month campaign. This brought together diverse wisdom and contributions to jointly support the construction of a COPD prevention and control system in China, assisting in the implementation of the "Healthy China 2030" strategy.

"2022 GSK COPD Awareness Month" Launch Ceremony

"Happiness Breathing" Project Supports "Prevention, Diagnosis, Control, Treatment, and Rehabilitation" Work

Chronic obstructive pulmonary disease (COPD) is a common chronic airway disease that frequently occurs in the autumn-winter season and elderly population. Its main symptoms include coughing, sputum production, and wheezing. Early symptoms are often hidden and non-specific, which leads to them being frequently overlooked or mistaken for the common cold. The latest research shows that the prevalence of COPD in people over 40 years old is 13.7%, while in those over 60 years old, it reaches more than 27%.^[1], representing a 67% increase compared to the 2007 survey results.^[2]. With the deepening of China's aging population, the contrast between the continuously rising prevalence of COPD and the low awareness rate, low diagnosis rate, and low control rate has become increasingly stark, with a missed diagnosis rate as high as 70%.^[1], the situation of prevention and control is very severe. The "China Chronic Obstructive Pulmonary Disease Graded Diagnosis and Treatment Report (2020)" shows that 64% of the public have "no knowledge at all" about COPD.^[3], with less than 3% of COPD patients aware of their condition.^[1]。

Ms. Kong Lingzhi, Standing Vice President and Secretary General of the China Health Promotion and Education Association, stated, "Health is the most important indicator of a happy life, and health education and health promotion are crucial pathways to advancing public health. As a national-level association, the China Health Promotion and Education Association has been committed to creating a friendly platform and environment for the development of the health education industry since its establishment. Five years ago, the 'Happy Breathing' project was officially launched, prospering alongside China's health initiatives. Five years later, we gather at the 5th CIIE to showcase the fruitful achievements made in health education and health promotion over these years. By the end of 2021, the project had helped more than 1.51 million grassroots people complete COPD questionnaires and provided pulmonary function tests for over 370,000 high-risk COPD individuals." The "Happy Breathing" project, carried out by the China Health Promotion and Education Association in collaboration with GSK, holds significant importance and will see further innovations and optimizations moving forward, supporting the implementation of China’s tiered COPD diagnosis and treatment system.

Professor Yang Ting, Director of the Clinical Diagnosis Department at the Respiratory Center of China-Japan Friendship Hospital, pointed out, "Based on the data from China's national census, it is estimated that our country has nearly 100 million patients with chronic obstructive pulmonary disease (COPD). In fact, the real number may be even higher, with one in every five people belonging to the high-risk group for COPD. The disease burden caused by COPD is severe and comparable to major chronic diseases like diabetes and hypertension, which require urgent attention. As the first point of diagnosis, primary care is also the main battlefield for COPD management, playing a key role in screening high-risk populations, regular follow-ups, and long-term treatment." Since 2017, the "Happy Breathing" project supported by GSK has been promoting the comprehensive coverage of COPD hierarchical diagnosis and treatment in pilot regions across all levels of medical institutions. Patients already diagnosed with COPD and those newly screened are entered into a long-term management system for standardized, ongoing care. Professor Yang Ting added, "The 'Happy Breathing' project, the National Debt project, and the COPD high-risk population screening and intervention project, three major national initiatives, complement each other, forming a synergy that provides unprecedented conditions and opportunities for the work of 'prevention, diagnosis, control, treatment, and rehabilitation.'"

Walking Out a "Chinese Characteristic" Path for COPD Prevention and Treatment

In recent years, chronic respiratory diseases have received extensive attention from the state and government in China, leading to the introduction of a series of policies for the prevention and treatment of chronic respiratory diseases. Chronic obstructive pulmonary disease (COPD) has become a key focus of these efforts. The "Healthy China Action (2019-2030)" released in July 2019 outlined 15 major initiatives, eight of which involve the prevention and treatment of respiratory diseases, with COPD occupying a significant portion. The goal is to increase COPD awareness to over 30% by 2030. In May 2022, the "14th Five-Year Plan for National Health" issued by the State Council once again emphasized improving the comprehensive prevention and control capabilities for chronic respiratory diseases and enhancing early screening and intervention for respiratory conditions.

Professor Chen Rongchang, Director of the Respiratory Disease Research Institute of Shenzhen People's Hospital, emphasized, "The Healthy China Initiative provides clear guidance on smoking control, increasing awareness and screening rates of COPD, respiratory rehabilitation, and improving environmental pollution, all related to COPD. As the world's most populous country, the characteristics of the COPD population in China are diverse. Apart from smoking, a recognized high-risk factor, our research in the remote Shaoguan area of Guangdong shows that the female smoking rate is only 0.6%. The high incidence of COPD in this region is due to indoor pollution caused by burning wood and grass in rural areas. Improving kitchen ventilation in rural areas and switching to gas can reduce the incidence of COPD." In addition to risk factors, the disease course of COPD patients in China also differs significantly from that in other countries. There are many early-stage COPD patients in community-level healthcare who are asymptomatic or have mild symptoms. For this group, early screening and diagnosis, as well as reducing the risk of future acute exacerbations, are among the most important treatment goals. "Pulmonary function testing is the 'gold standard' for diagnosing COPD and is essential for its early diagnosis. On one hand, we urge high-risk groups—those with a history of smoking or exposure to biomass fuels, or those with long-term occupational dust exposure—to undergo timely pulmonary function tests to screen for COPD. On the other hand, we are promoting the widespread use of spirometers and providing training for healthcare personnel at the grassroots level to ensure they do not miss the opportunity for the early diagnosis and treatment of COPD."

Long-term standardized treatment is the core to avoiding acute exacerbations

Acute exacerbations of COPD and complications involving other organ damage are the "culprits" that accelerate disease progression and ultimately lead to death. The impact of just one acute exacerbation can result in accelerated deterioration of lung function, reduced daily activity capacity, and an increased risk of various comorbidities and mortality. Recurrent acute exacerbations will further worsen the patient's health condition, with a 5-year survival rate of less than 50% for such COPD patients.^[4]Data shows that, on average, Chinese COPD patients experience three acute exacerbations per year.^[5], imposing a heavy physical and mental burden on patients and their families, and seriously threatening their quality of life and health status.

Professor Song Yuanlin, Director of the Department of Respiratory and Critical Care Medicine at Zhongshan Hospital Affiliated with Fudan University, stated, "COPD cannot be cured, and each exacerbation causes irreversible damage to lung function, increasing mortality. We often encourage patients and their families to recognize the signs of acute exacerbations and equip themselves with knowledge on managing mild acute exacerbations to prevent problems before they occur. In this context, the CERT card—an acute exacerbation risk identification tool—developed by international authority Professor Paul Jones and Chinese experts based on characteristics of Chinese patients, has emerged. It allows for quick, simple, and visual identification of whether a patient is experiencing an acute exacerbation, thereby promoting early diagnosis and treatment of COPD and reducing acute threats." Preventing acute exacerbations requires long-term standardized management during stable periods. As the primary person responsible for their own health, patients should adopt the concept of long-term standardized treatment, persistently taking medications as with hypertension and diabetes, truly slowing disease progression, alleviating symptoms, and reducing the frequency of flare-ups. "The most concerning issue for doctors regarding COPD patients is non-compliance with medication. One issue is discontinuing medication when it’s needed, and another is incorrect use due to lack of understanding, both of which lead to repeated illness, declining lung function, frequent comorbidities, and eventual hospitalization due to acute exacerbations. Every time we prescribe medication, we repeatedly emphasize these two points to ensure patients fully understand."

Early intervention in COPD has a positive impact on disease prognosis

Professor Hui-Li Zhu from the Department of Respiratory and Critical Care Medicine at Huadong Hospital, Fudan University, stated, "Although COPD is not yet curable, it is preventable and treatable. There are many patients with mild COPD in daily life who generally already exhibit symptoms of coughing and sputum production, and even slight breathing difficulties, but their lung function remains normal. If these patients are not intervened, they may gradually develop into COPD, which can further lead to irreversible lung function damage—like a rubber band that, once slackened, will never fully regain its elasticity. Smoking is widely recognized as the main risk factor for COPD, but Chinese 'smokers' often harbor侥幸psychologies and misconceptions because they have not seen severe COPD patients and are unaware of the consequences of the disease." To further enhance public awareness of COPD, Professor Hui-Li Zhu and her colleagues have consistently held free clinics on disease days such as "World COPD Day" over the years, helping increase awareness of COPD among the general population, disseminating relevant knowledge to patients with mild COPD, and promoting the prevention and control of COPD. "COPD is not a disease that occurs suddenly; everyone should strengthen their understanding of this disease, manage themselves well, and prevent tragedies from recurring," emphasized Professor Hui-Li Zhu earnestly.

As a leading global enterprise in the respiratory field, GSK actively responds to the "Healthy China 2030" initiative and the "14th Five-Year Plan," collaborating with various forces across society, including the government, academia, and institutions. Through multiple channels, levels, and dimensions, GSK strives to enhance public awareness of COPD. The launch ceremony of the 2022 COPD Awareness Month held during this event is yet another powerful measure in fulfilling its commitment to respiratory health. The World Health Organization designates the Wednesday of the third week in November each year as "World COPD Day." To further strengthen public understanding of the disease, GSK will conduct over 100 science popularization lectures and free clinics in nearly 50 cities across China in collaboration with regional medical consortium institutions during the high-incidence season of COPD in autumn and winter. The initiative aims to reach 10,000 people, helping the public in different regions of China better understand the dangers of COPD, identify acute exacerbations earlier, improve disease management capabilities, and build a brighter future where everyone can "breathe freely."

^[1] Wang C, Xu J, Yang L, et al. Prevalence and risk factors of chronic obstructive pulmonary disease in China (the China Pulmonary Health [CPH] study): a national cross-sectional study. Lancet. 2018;391(10131):1706-1717. doi:10.1016/S0140-6736(18)30841-9

^[2] Zhong N, Wang C, Yao W, et al. Prevalence of chronic obstructive pulmonary disease in China: a large, population-based survey [published correction appears in Am J Respir Crit Care Med. 2007 Dec 1;176(11):1169]. Am J Respir Crit Care Med. 2007;176(8):753-760. doi:10.1164/rccm.200612-1749OC

^[3]Wang Chen. Report on the Graded Diagnosis and Treatment of Chronic Obstructive Pulmonary Disease in China (2020). People's Medical Publishing House. 2022,7.

^[4] Suissa S, et al. Thorax. 2012 Nov;67(11):957-63.

^[5] Lim S, et al. Asia Pacific Family Medicine. 2015, 14(4): 1-11.