Practice support for AAT deficiency in COPD or treatment-resistant asthma
Many patients with COPD see healthcare providers other than pulmonologists.1 Optimal recognition of alpha1-antitrypsin (AAT) deficiency will require enhanced surveillance by all communities of clinicians who see at-risk patients, including primary care providers (eg, family physicians and general internists), nurse practitioners, physician assistants, and, given their frequent interaction with patients with COPD or treatment-resistant asthma, especially respiratory therapists (RTs).1
Five major clinical organizations recommend screening tests for AAT deficiency in all patients with COPD or treatment-resistant asthma.2-6
The role of respiratory therapists in diagnosing AAT deficiency
Respiratory Therapists (RTs) are often on the front lines of care for COPD patients: in pulmonary function laboratories, in pulmonary rehabilitation, in post-acute settings (long-term acute care and skilled nursing facilities, homecare), or in ambulatory care settings, where they are in a position to see and recommend AAT deficiency screening tests for at-risk patients with COPD or treatment-resistant asthma.1
Comprehensive COPD care includes screening tests for AAT deficiency
RTs can counsel and encourage patients as well as implement AAT deficiency screening test protocols with the Medical Director's approval. Ruling out AAT deficiency with AlphaID™ can be easily incorporated into your workflow.
- The AlphaID™ AAT deficiency screening test fits easily into pulmonary function test (PFTs) routines
- AlphaID is fast so that it can be incorporated either pre- or post-bronchodilation
- Screening all patients with COPD or treatment-resistant asthma patients for alpha-1 will help to ensure that you are providing comprehensive care
You can make a difference by ruling out AAT deficiency with AlphaID™
Hear experienced healthcare professionals discuss the importance of screening for alpha-1
“I would suggest that all practices choose an alpha-1 champion to take this program and follow it from start to finish to get those patients tested and then follow those results so they can begin treatment [if needed].”
“I screen everyone with a diagnosis of COPD regardless of age of diagnoses, smoking exposure history, or their heritage. In addition, I screen everyone with asthma with incomplete bronchodilator reversibility.”
“Alpha-1 has a wide variety of presentations, and there is no way to clinically diagnose it. What it really is, is a laboratory diagnosis… and shifting your brain from ruling it in to ruling it out.”
“I was always working under the assumption that [this disease], like cystic fibrosis, is a Caucasian disease. No...When you look at the data, sure enough you should screen African Americans and Hispanics too.”
Nurse practitioners in AAT deficiency
In the primary care setting, nurse practitioners (NPs) are often on the front lines of care for COPD patients when it comes to supporting their practices.7 NPs play an increasingly important role in primary care, and must be well versed in a variety of conditions.7 NPs can help facilitate the earlier detection of AAT deficiency and improve rates of diagnosis.7
Rule out AAT deficiency
No specific respiratory symptoms point to definitive detection or diagnosis of AAT deficiency within the COPD population.7 As a result, AAT deficiency cannot be detected by physical examination alone.1,2 Given the heterogeneity in the presentation for AAT deficiency, the strategy for identification should be to rule out AAT deficiency7:
- AlphaID™ is a fast, free, and accurate alpha-1 screening test that uses a cheek swab DNA collection method
NPs can further contribute to the effective care of patients with AAT deficiency by conducting educational programs or by directing patients to them.7
Downloads for Healthcare Professionals
From an in-depth examination of the disease state to tips on counseling patients diagnosed with the condition, download the information you need to make screening for AAT deficiency a routine part of care.
For a complete list of resources, please visit this link.
What is Alpha-1? Brochure
An overview of AAT deficiency that includes symptoms, current statistics, and the benefits of screening and testing from the Alpha-1 Foundation.
Alpha-1 Genetic Counseling
Program Guide
A guide for healthcare professionals (HCPs) about the Alpha-1 Foundation’s program on testing, diagnosis, and genetic counseling of AAT deficiency.
Alpha-1 and COPD Care Brochure
All HCPs need to know about the benefits of adopting AAT deficiency screening practices within COPD care settings.
Up Next: What is AlphaID?
References:
- Stoller JM, Strange C, Schwarz L, Kallstrom TJ, et al. Detection of Alpha-1 Antitrypsin Deficiency by Respiratory Therapists: Experience With an Educational Program. Respir Care. 2014;59(5):667-672.
- American Thoracic Society/European Respiratory Society. American Thoracic Society/European Respiratory Society statement: standards for the diagnosis and management of individuals with alpha-1 antitrypsin deficiency. Am J Respir Crit Care Med. 2003;168(7):818-900.
- Sandhaus RA, Turino G, Brantly ML, et al. The diagnosis and management of alpha-1 antitrypsin deficiency in the adult. Chronic Obstr Pulm Dis. 2016;3(3):668-682.
- 2024 Gold Report - Global Initiative for Chronic Obstructive Lung Disease. GOLD. November 12, 2023. Accessed May 2, 2024. https://goldcopd.org/2024-gold-report/.
- World Health Organization. α1-antitrypsin deficiency: memorandum from a WHO meeting. Bull World Health Org. 1997;75(5):397-415.
- Campos MA, Wanner A, Zhang G, Sandhaus RA. Trends in the diagnosis of symptomatic patients with α 1 -antitrypsin deficiency between 1968 and 2003. Chest. 2005;128(3):1179-1186.
- Newell JA. Donahue C, Hogarth DK. An NPs guide to diagnosing and treating alpha-1 antitrypsin deficiency. Nurse Pract. 2019;44(4):13-21.