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Chronic obstructive pulmonary disease (COPD)

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Doctor reviewing a Chronic obstructive pulmonary disease patient's chest x-rayAbout chronic obstructive pulmonary disease.

Chronic obstructive pulmonary disease (COPD) affects about 1.2 million people in the UK making it the second most commonly diagnosed respiratory disease. The number of patients with COPD has been steadily increasing and the predominantly older (>60 years) patients often present with varying degrees of emphysema and chroninc bronchitis.

Diagnosis of COPD generally requires spirometry and a chest x-ray and blood counts to exclude anaemia and polycythaemia as well as calculations of body mass index (BMI) and oxygen saturation.

A critically important first step in the management of COPD is smoking cessation, where appropriate.

Other common interventions include pneumococcal and annual influenza vaccinations and dietary intervention to promote weight loss.

Inhaled corticosteroids, long acting muscarinic antagonists and long acting beta agonists (LABAs) are the foundation of therapy for Chronic obstructive pulmonary disease – underling the importance of educating patient to use their inhalers appropriately.

Diagnosing COPD: Putting the jigsaw together

Diagnosing chronic obstructive pulmonary disease (COPD) can be complex and requires
considerable clinical skill. It is rather like putting together the pieces of a jigsaw
puzzle. But don’t despair. In this article, we take you through the key steps. A careful
history, particularly in smokers or ex-smokers who complain of breathlessness,
followed by clinical examination may indicate possible COPD. Further steps must then be taken
to exclude other causes of respiratory symptoms and spirometry is essential in diagnosing
airflow obstruction, which may help to confirm the diagnosis of COPD.

Back to Basics: Is it COPD or asthma?

To be able to effectively manage patients with
airflow obstruction in general practice it is
imperative that we can differentiate between
asthma and chronic obstructive pulmonary disease
(COPD). Although COPD and asthma share many
clinical features, they are different conditions with
different airway inflammation and parenchymal
patterns.

Why Optimise Inhaler Technique in Asthma and COPD?

Asthma UK estimates that 2.1 million patients in the UK are suffering unnecessarily because
they do not use their asthma treatment effectively. This article looks at how inhaled
therapies are deposited in the lungs, and at the basic differences between inhalers – with
a focus on optimising inhaler technique.

The effects of the weather on COPD

Those of us working with patients suffering from COPD know anecdotally that cold
weather directly impacts exacerbation rates and hospital admissions in the same way
as thunderstorms affect those with asthma (see BJPCN Vol 1, Issue 2, March 2007).
This article explores the links between COPD and weather patterns. You may not want
to be thinking about the winter but action now should give time to put preventive systems in
place to help at-risk patients before the cold weather appears again.

The Challenges of Scoring QOF Points for Asthma and COPD

The Quality and Outcomes Framework (QOF) is now well into its third year and continues
to expand boundaries of quality domains within chronic disease management. In this
article we review some of the challenges in QOF indicators for asthma and COPD and
suggest some tips to make the requirements easier to achieve in daily clinical practice.

The breathless patient: Is it asthma or COPD?

Breathlessness is a very common problem in the patients we see in general practice, and
there is a range of possible causes. In this article – the first in a series of three looking
at how to diagnose what’s wrong with a breathless patient – we explore how to
distinguish between two of the commonest respiratory causes of breathlessness,
asthma and chronic obstructive pulmonary disease.

Preventing and Treating COPD Exacerbations

Acute exacerbations of chronic obstructive pulmonary disease (COPD) are common and
have serious implications. They greatly reduce patients’ quality of life and often result
in hospital admissions. Acute exacerbations of COPD are the largest single cause of
emergency respiratory admissions and each exacerbation results in an average hospital
stay of 10.3 days. In this article we review what causes exacerbations in patients with COPD and
how you can help to prevent and treat them effectively.

Oxygen Therapy for COPD: How to use it Safely

Oxygen therapy for patients with chronic obstructive pulmonary disease (COPD) has
recently been hitting the headlines, because major changes in its supply – using
independent contractors – introduced last year initially caused problems in some areas.
In this article, we review why some patients with COPD need oxygen therapy, when it
should be used and how to use it safely.

Editorial: COPD

Being able to take a deep breath of fresh air is something that most of us take completely for granted. But for our patients with asthma, chronic obstructive pulmonary disease (COPD), other respiratory diseases such as sleep apnoea, and allergic disorders such as rhinitis, taking a deep breath may not be so easy.

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