Chronic obstructive pulmonary disease
As costs of respiratory illnesses continue to rise, a recent report has criticised the lack of progress in tackling lung disease and COPD
An estimated three million people have chronic obstructive pulmonary disease (COPD) in the UK, but less than a third are diagnosed. COPD refers to a group of lung conditions that make it difficult to empty air out of the lungs because the airways have narrowed.
Two of these lung conditions are persistent bronchitis, when the airways are inflamed and narrowed; and emphysema, which causes the air sacs at the end of the airways to break down. These conditions can also happen together.
COPD costs the UK £1.9 billion a year, according to a report from the British Lung Foundation. The total costs of all respiratory illnesses were found to be £11 billion a year: £9.9 billion on the NHS and patients in private costs and £1.2 billion on the wider economy through days lost at work. The report, Estimating the Economic Burden of Respiratory Illness in the UK, criticised the lack of progress in tackling lung disease.
Lung disease is the third biggest killer in the UK and COPD is the only major cause of death on the increase.
Signs and symptoms
Symptoms include getting short of breath easily during walking and everyday activities, a long-lasting cough, wheezing in cold weather, and producing excess sputum or phlegm. In severe COPD, patients may lose appetite, lose weight and have swollen ankles.
Causes and risk factors
People over 35 years old and who are, or have been, smokers are most likely to develop the condition. Smoke from other sources, air pollution and jobs that expose people to dust, fumes and chemicals can also contribute to the disease.
How you can help your patient
Consider COPD in patients with symptoms to support early diagnosis and access to treatment. Regardless of age, encourage all COPD patients who are still smoking to stop, and offer help to do so at every opportunity. All suitable patients should be offered pulmonary rehabilitation, with physical training, disease education, nutritional, psychological and behavioural interventions. Be alert to the presence of depression or anxiety in patients with COPD.
Jane Scullion – respiratory nurse consultant at University Hospitals of Leicester NHS Trust
‘While a lot of the messages around COPD can seem quite negative, there is much that can be done to help people manage their symptoms well. Breathlessness can have the biggest impact on patients, but while uncomfortable, it is not dangerous. It can stop people taking any exercise, which becomes a vicious cycle and makes the symptoms worse.
‘Advice such as using a towelling dressing gown to dry with instead of towels can help people manage breathlessness and stay independent. Nurses should always check that patients understand and can take their medication correctly. I see a lot of older people having problems with inhalers, for example.’
- British Lung Foundation (2016) Estimating the Economic Burden of Respiratory Illness in the UK
- NICE guidance (June 2010) COPD in over 16s: Diagnosis and Management (currently being updated)
- Global Initiative for Chronic Obstructive Lung Disease (2016) Global Strategy for Diagnosis, Management and Prevention of COPD
- Nursing Standard (January 2013) Chronic obstructive pulmonary disease: diagnosis and management