Respiratory

Anxiety in Patients with Respiratory Disease

Anxiety is a significant problem for many patients with respiratory disease and can have
a very negative impact on the disease course and prognosis. Practice nurses have an
important role to play in identifying anxiety and referring patients for appropriate
treatment. This article will focus on anxiety in such patients and aims to help you
understand what anxiety is, how anxiety affects patients, how to recognise symptoms of anxiety
and how to use the Hospital Anxiety and Depression Scale. A second article, to be published in
the next issue, will focus on management of anxiety.

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)?

Back to Basics: Drugs for asthma – where and how do they work?

The Evaluation and Management of Cough in Adults

Cough as a symptom results in significant impairment of quality of life for patients. Its
wide and varied causes and presentations make diagnosis and management complex.
Many sets of guidelines have been produced to help clinicians in the evaluation and
management of acute and chronic cough. This article uses the British Thoracic Society
(2006) guidelines to provide a summary of the evaluation and management of cough.

Occupational asthma: how to help the wheezy workers

Approximately one in every ten cases of adult-onset asthma is attributable to
occupational exposure. Unless occupation is considered, a diagnosis of occupational
asthma will be missed so it is likely to be underdiagnosed. An average practice with
around 6,000 patients will typically have approximately 600 adult patients with asthma,
of whom 60 may have occupational asthma if we assume 10% of cases are related to
occupational exposure. Can you think of 60 patients with occupational asthma in your practice?

Editorial: Winter

You may have thought you were safe from dire warnings about global warming in the pages of BJPCN. But hayfever is one of the themes of this issue and the mild winter has meant that some people suffered symptoms much earlier than usual as pollens which can trigger allergic reactions were found in the air as early as January.

Anticholinergics: How do they Work?

Anticholinergic drugs are bronchodilators that act by blocking acetylcholine, the
neurotransmitter for the parasympathetic nervous system. By blocking parasympathetic
stimulation, anticholinergics reduce cholinergic tone, therefore producing
bronchodilation. In this article we review when and how these drugs should be used.
What are their potential benefits and what should we tell patients who need them?

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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