Aquarius Population Health

COPD was the third leading cause of mortality worldwide in 2019 (1), responsible for 3.23 million deaths (2). Improved understanding of the common barriers to care delivery could inform international approaches to improving care standards and patient outcomes.

Evidence Care Pathways (ECPs) were created to bring to life the story of how COPD care is currently delivered in Japan, Canada, England and Germany. Published epidemiological, clinical, and economic data was used to populate the ECPs. Thematic content analysis was performed on the clinician interviews (twenty-four respiratory healthcare professionals in primary and secondary care) to inform and validate the ECPs.

The results of this work published in the International Journal of Chronic Obstructive Pulmonary Disease identified three key themes relating to barriers to optimal COPD management across the countries: journey to diagnosis, treatment and management, and the impact of COVID-19. Presentation to healthcare with advanced COPD, low consideration of COPD by patients and healthcare professionals, and sub-optimal acute and chronic disease management were common across all countries. COVID-19 has negatively impacted disease management across the pathway – but has also opened opportunities for virtual consultations.

COPD is a significant public health issue that needs urgent prioritisation. The common barriers to optimal COPD care identified across the four studied countries highlight the continued need for strategies to optimise COPD care, particularly as the burden of COPD continues to grow.

The Evidenced Care Pathways for the four countries can be downloaded here. Please download this document and open it in a PDF reader such as Adobe for full functionality.

This study was funded and commissioned by AstraZeneca.

Meiwald A, Gara-Adams R, Rowlandson A, et al. Qualitative Validation of COPD Evidenced Care Pathways in Japan, Canada, England, and Germany: Common Barriers to Optimal COPD Care. Int J Chron Obstruct Pulmon Dis. 2022;17:1507-1521


1. WHO. The top 10 causes of death. Accessed October 22, 2021.

2. WHO. Chronic obstructive pulmonary disease (COPD) fact sheet. Published 2021. Accessed August 18, 2021.

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