GARD - Czech Experience Burden of Chronic Respiratory Diseases Initiatives for Their Control V.Kolek Czech Pneumological and Phthiseological Society
Epidemiological burden of respiratory diseases in the Czech Republic (10.2 mil) Tuberculosis: incidence 9.5/100 000 COPD: prevalence 7.78 % (780 000), mortality in men 19.1/100 000, in women 4.9/100 000 Asthma bronchiale: prevalence 8% (800 000), incidence 40 000/y Lung cancer: mortality in men 89/100 000, in women 24/100 000 ILD: incidence of IPF 1.2/100 000, sarcoidosis 2.6/100 000 Pneumonia: hospitalization: 23 000, mortality 22.3/100 000 Bronchiectasis, primary pulmonary hypertension: data not known Cystic fibrosis: 33/100 000 inborns
Notification of TB in CR 1958-2005 20000 15000 10000 5000 0 1958 1962 1966 1970 1974 1978 1982 1986 1990 1994 1998 2002
TB according age cohorts /100 000 inhabitants,, CR 2005 men 40 20 0 0-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75+
TB according age cohorts /100 000 inhabitants,, CR 2005 women 40 20 0 0-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75+
Prevalence of COPD stages CR 2005 8% 0% 23% 31% 38% st.1 st.2 st.3 st.4 231 000 pat.
Prevalence of asthma stages 9% CR - 2005 25% 31% 35% IA MiPA MoPA SA
Number of hospitalized for asthma in the Czech Republic 1995 95-2004 12000 10000 8000 6000-34 % Total no. of persons Linear (Total no. of persons) 4000 1995 9 870 2000 1997 8 934 1999 8 841 0 2001 8 195 ÚZIS 1995 1997 1999 2001 2002 2003 2004 2002 7 234 2003 7 029 2004 6 503
Lung cancer mortality in CR year 1950 1960 1970 1980 1986 1990 1995 2000 men 1 083 3 152 4 641 5 100 5 124 4 979 4 704 4 480 women 252 386 511 638 767 851 1 091 1 246
Medical societies and civic associations medical societies ČLS JEP Czech Medical Society of Jan Evangelista Purkyně - 34 636 physicians, 102 specialized medical societies, 43 regional associations (360 alergologists, 565 pneumologists) Specialized societies (doctors, health care only) are not independent legislative subjects, they organize medical meetings, postgraduate education, take part in reimbrusment procedures civic associations and patient inciatives ČOPN Czech Civic Association against COPD ČIPA Czech Inciative for AB Being independent legislative subjects (doctors, own administration), they can more effectively educate patients, organize courses, print books, teach self monitoring
Societies and associations potencially cooperating with GARD Česká společnost pneumologie a ftizeologie ČLS JEP Česká společnost alergologie a klinické imunologie ČLS JEP Pracovní skupina pediatrické pneumologie České pediatrické společnosti ČLS JEP Společnost pro léčbu závislosti na tabáku ČLS JEP Společnost všeobecného lékařství ČLS JEP Odborná společnost praktických dětských lékařů ČLS JEP ---------- Národní centrum pro těžké astma (NTA) Správní rada České iniciativy pro astma o.p.s. (ČIPA) České občanské sdružení proti chronické obstrukční plicní nemoci (ČOPN) ----------- Klub pro cystickou fibrózu Sdružení pro alergické a astmatické dětí (SAAD), Brno Sdružení na pomoc chronicky nemocným dětem, Praha Nadace ASTMA Sdružení respiriků, Hradec Králové Klub astmatiků, Olomouc
Czech Iniciative for Asthma ČIPA, o.p.s. ČIPA was founded and established in 1996 as a non-profit NGO by three medical societies Czech Society of Allergology and Clinical Immunology Czech Society of Pneumology ant Phthiseology Czech Society of Respiratory Physiology and Pathophysiology Activities Implementations and acceptance of GINA and ARIA documents in local medical practice National Guidelines for Asthma Management Courses: Asthma Management for GPs and for nurses
Czech Association against COPD- ČOPN ČOPN was founded and established in 2000 as a non-profit NGO by Czech Society of Pneumology and Phthiseology Activities ContinuaI implementations and acceptance of GOLD documents in local medical practice National Guidelines for COPD Weekend courses: COPD for GPs and for nurses Fighting for nonsmokers rights
Consumption of antiasthmatic medication in the CR in 1999-2005 (DOT days of treatment) Antiastmatika v ČR 1999-2005 v DOT 100% DOT 90% 80% 70% 60% 50% 40% 30% 20% 10% Theophyllines Cromoglycates Antileukotrienes SABA Anticholinergics LABA ICS Fixed combination 0% DOT Year/99 DOT Year/00 DOT Year/01 DOT Year/02 DOT Year/03 DOT Year/04 DOT Year/05 IMS
Role of pneumologists in GARD We understand GARD activity as an integrated approach, which should be extended to all chronic respiratory diseases, particularly since many of them share similar risk factors. Pneumologists should be reponsible for assessing all respiratory diseases and risk factors globally and to determine the major problems for our society. Information needs to be provided to educate people about risk factors and their effects
Strategy of the Czech GARD To find a cooperating partners from the govermental environment (after the period of political hesitations) To join all medical and civic subjects dealing with CRD To improve the level of respiratory medicine and increase its power in the Czech Republic To inform the public institutions about the huge social burden of respiratory diseases
Visions of Czech pneumologists Continual inovation of respiratory medicine Entering research programmes of national agencies,, EU funds, frame programmes Up grading of interventional pneumology Establishing national programme of COPD Co-organisation organisation of national oncological centres Better equipment of therapeutic bronchology centres Discussing changes of the BCG vaccination system Realize a continual care of respiratory diseases
freely breathing society patients doctors political lobbying mass media sponsors partners