COPD Management in Rural SC

COPD Management in Rural South Carolina

Sponsor/Type: South Carolina Center for Rural and Primary Healthcare
Project Period: 01/01/2023 – 12/31/2024

Purpose and Description of Need

Chronic obstructive pulmonary disease (COPD) is a prevalent chronic respiratory disease and currently, the fourth leading cause of death and fourth main cause of disability in the United States. COPD exacerbations are a significant clinical problem associated with impaired lung function, decreased quality of life (QOL), and compromised mental health. Exacerbations requiring services such as emergency department (ED), or hospital admission add to the financial burden for patients with high out of pocket costs for such services.

Further, the costs associated with required equipment to manage the decline in health increase the overall care management expenses. Additional types of equipment include oxygen, non-invasive ventilation, and mobility devices such as walkers and wheelchairs. The increased numbers of aging patient populations, healthcare staffing shortages, and health literacy needs further add to the complexity of COPD management.

Target Population

Rural populations have higher rates of COPD due to increased exposure to airway pollutants and higher rates of smoking (CDC). Limited access to smoking cessation resources, specialized respiratory care, and equipment is an additional barrier for patients with COPD who live in rural areas. Patients in these areas face disproportionate access challenges as there is a lower ratio of providers to patients and a growing aging population with multiple care needs (including multimorbidity from other chronic conditions).

MUSC is widely distributed including telemedicine services to the entirety of the lower half of the state with high density rural populations. As we roll out this program in MUSC clinics serving rural areas, we will capture zip codes of individual patients in rural areas of SC counties (including Lancaster, Chester, Kershaw, Darlington, Williamsburg, Bamberg, Marion, Georgetown, Jasper, and Beaufort).


COPD management is accomplished through appropriate screening and proper diagnosis, clinical care management, pulmonary rehabilitation, and self-management by the patient. Health behaviors, including maintaining regular vaccinations such as the pneumococcal vaccine, appropriate inhaled medications for the stage of disease, and a focus on non-medication care including regular exercise are all important.

Each of these aspects can be affected by access, economical, and environmental barriers. Research has shown achieving better health outcomes can be accomplished by addressing these barriers and optimizing communication between providers and the patient.

For more information contact
Sarah Miller
Ph.D., RN