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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.

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.

Optimising nutrition in COPD

Although principally an inflammatory respiratory disease, chronic obstructive pulmonary
disease (COPD) is now recognised as a complex disorder that also manifests in
extrapulmonary and systemic effects. Nutritional manifestations of the disease, notably
weight loss and obesity, have been recognised. However, the complexity of nutritional
problems in COPD has been poorly understood, and the consequences largely underrated. Now,
linked to increasing knowledge regarding systemic inflammation, it is becoming clear that poor
nutritional status is not only a manifestation of COPD but also a predictor of mortality and
healthcare utilisation.

Making the most of self-management plans in COPD

The Department of Health’s Expert Patient Programme recognises the role of selfmanagement
in many different disease areas and its report Self Care recommends the
concept of encouraging people with long-term conditions to self-manage where
possible. Diabetes management would never succeed without the active participation of
the person with the condition and asthma management plans have been advocated for some
time for people with asthma. What can self-management plans achieve in chronic obstructive
pulmonary disease (COPD)?

How to care for patients with end-stage COPD

Practice nurses often get to know their patients with chronic obstructive pulmonary
disease (COPD) very well. Over the years, they have attended for reviews, flu injections
and when they have exacerbations. Nurses get to know their families as well as the
patient, and it can be hard to observe the inevitable deterioration as the condition
progresses. This article will outline some of the key issues for practice nurses when their patients
start to have frequent hospital admissions or cannot attend the surgery for reviews. Has their
condition become palliative, and what can practice nurses contribute to their care?

Exercise in chronic lung disease

Chronic obstructive pulmonary disease (COPD) is the term used to describe a range of
chronic chest conditions, including chronic bronchitis and emphysema. COPD is
characterised by permanent damage to the lungs and as the condition develops, people
experience increasing breathlessness, to the point where even everyday activities such
as getting dressed or walking up stairs become difficult. This article describes the impact of
COPD, explores the value of exercise in COPD management and discusses possible reasons for its
widespread under-use as effective symptom control.

Editorial: Winter, respiratory infections and COPD

What a winter we have had! Many children have seen heavy snow fall for the
first time and London was completely immobilised due to the weather. At the
same time our hospitals have been battling to cope with patients suffering with
respiratory infections and exacerbations of their COPD. GP practices have been
stretched to the limit to cope with the additional burden of coughs and colds.
Building capacity is a real problem for everyone working in the health service and
patients’ demands and expectations continue to grow.

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.

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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