The criteria used for the assessment of disability do not reflect the intensity of the symptoms of respiratory patients.

-respiratory diseases alternated periods of normalcy with periods of high functional limitation

-current disability situation not covered adequately the difficulties involved in activities of daily living of patients with respiratory disease

– most of the respiratory functional explorations are carried out at restwhich provides some not entirely real results

– need a spread between doctors and specialists of legal criteria for disability and their way of valuing them

Spain, March 2012.- the Spanish society of Pneumology and thoracic surgery (SEPAR) said on Tuesday in the multidisciplinary meeting of minority respiratory diseases that has taken place in Lleidaan analysis of the current state of the measurement of disability in respiratory patients. The criteria used to determine the disability of any system are regulated by the Ministry of labour and Social Affairs. This assessment, in the case of respiratory diseases is especially complicated that it’s chronic processes interrelated with other systems and also with occasional outbreaks, alternating periods of normalcy with major functional limitation periods ”, explains the DRA. Immaculate Alfageme, signatory of the document already accessible on-line in the journal archives of Bronconeumología and President of the Committee of quality healthcare of SEPAR. Another problem added to a fair valuation, is the lack of a multidisciplinary approach to consider the patient as a whole, since the symptoms involving respiratory diseases can affect turn others systems ”, considers the DRA. Alfageme.

Currently, the order in the General Law on Social Security establishes situations subject of coverage, benefits, and requirements for access to surveys of disability. Said system assesses the situation of disability from two perspectives: neurological disabilities and trauma, both disability in different degrees and multiple scenarios. However, these perspectives frame of diffuse the allocation of disability attributable to shortcomings in the respiratory system.

Unlike other pathologic processes, the respiratory patient does not show an image of physical disability apparent to society and to the legislation on disability because the scales of disability were established based on physical limitations. The disability cannot be seen if the patient is at rest, but why not longer crippling ”, explains the DRA. Beatriz Lara, co coordinator of the year 2012 SEPAR of diseases respiratory minority, in which fits the encounter of Lleida. I can wear solo, I can walk, I can wash me. But I need an hour to get the clothing because I asfixio, takes me half an hour in the path up to the kiosk because I need to stop me about 5 times, I ducho sitting because I I fatigo standing, need they help me to dry me hair because I can hardly breath holding the dryer or I can not go to the cinema because the cough annoyed others ”It explains Mª Luz Vila, co coordinator of SEPAR 2012 and President of the Association of LAM (Lymphagioleiomyomatosis), as an example of how can affect a patient a chronic neumológica disease.

Existing treatments to relieve such symptoms, such as oxygen or inhaled medication, are not perceived as an orthopaedic aid and in the majority of cases, are not popularized in the same way as a plaster or a crutch, being equally essential. All citizens have the right to comprehensive and free health care irrespective of the condition that suffer. Since this right guaranteed to health care, health resources must be accessible to citizens and this also involves access to techniques, treatments or experts in the case of very specific processes.

Considering the fact that respiratory diseases make them vulnerable to those affected to inequalities by the difficulty of diagnosis, the complexity of the explorations and treatments available and the fact of the chronic condition, there are some general rules for the valuation of such deficiencies caused by diseases of the respiratory system; and they can be quantified by means of objective evidence. SEPAR is located in dispósición for advising health authorities, company doctors and the péritos in clinical, functional criteria and explorations with further scientific evidence and reliability for the correct and accurate assessment of chronic respiratory patients.

In the assessment of the patient are not incorporated routinely quality of life questionnaires, while in recent years these quality measures have been imposed on patients with disease respiratory to the evidence that the functional parameters not isolation reflect capacity to carry out their work or their daily activity. Most of functional respiratory exploration are at rest.

After this assessment of the situation, the analysis also proposes some lines of work that would improve the existing scenario and delimit this assessment for specific pathologies. Dissemination of legal criteria for disability and their way of valuing them, through initiatives such as workshops or courses that teach to make functional assessments is necessary. Also, is required to include a number of determinations in interstitial diseases may be representative of the degree of illness, the validation of the cut-off points for the spirometry with other more representative global parameters and more related to quality of life and mortalitythe inclusion of radiographic parameters and defining best parameters that reflect the deterioration of a patient for each disease in particular, separating the EPOC of the general group.

The will of SEPAR is update, responding to the request of associations of patients with respiratory diseases that require a revision of the current criteria.

Have done an analysis of the current situation, both of the applicable legislation in matters of incapacity for work, and the determination of the degrees and percentage of disability, as well as the existing criteria for the allocation of disability attributable to deficiencies of respiratory ”, says Dr. Eusebi Chiner, Secretary general of SEPAR.