Clinical update


Chronic obstructive pulmonary disease (COPD) covers a number of lung conditions, including emphysema and chronic bronchitis.

Essential facts

Chronic obstructive pulmonary disease (COPD) covers a number of lung conditions, including emphysema and chronic bronchitis. People with COPD have lung damage that is not fully reversible. These conditions kill about 30,000 people a year in the UK. There are believed to be three million people living with COPD in the UK; however, more than two million people remain undiagnosed, with many dismissing their symptoms as a smoker’s cough.

The British Lung Foundation (BLF) has published a new COPD self-management pack for nurses to share with their patients. The packs are intended to help patients take better control of their condition, as well as avoid flare-ups and hospital admissions. Currently, COPD is the second leading cause of emergency admissions in the UK, with about 94,000 admissions a year.

The symptoms of COPD include wheezing, particularly when breathing out, breathlessness, tight chest, cough, and producing more mucus or phlegm than usual. Severe COPD can lead to weight loss, loss of appetite and ankle swelling.

The airways or the air sacs in the lungs, or both, become inflamed and damaged. This causes the airways to become narrower, making it harder to breathe.

COPD mainly affects people over the age of 35. Smoking is the main cause. Long-term severe asthma can also cause the condition, as well as long-term exposure to air pollution, fumes and dust.

The BLF says that the earlier that people are diagnosed with COPD, the greater the window of opportunity for intervention. Stopping smoking and starting regular exercise as soon as possible are evidence-based treatments for improving the symptoms of COPD.

Guidance from the National Institute for Health and Care Excellence (NICE) says that spirometry should be performed at the time of diagnosis, and to reconsider the diagnosis, if patients show an exceptionally good response to treatment. An up-to-date smoking history should be taken for every patient.

Nurses play an important role, not only in recognising any established symptoms of COPD, such as breathlessness and persistent cough, but also in identifying those people at risk of the disease who may not yet be symptomatic and ensuring an early diagnosis and early intervention.

Expert comment

Ren Lawlor, BLF professional and senior lecturer in nursing, University of Greenwich

‘Living with COPD can have a devastating impact on a person’s physical and mental health. Self-management is one of the most important components of COPD management, encompassing everything from improving a person’s understanding of their disease to helping with smoking cessation, inhaler technique and safe, effective exercises. This can help a person living with COPD to take control of their condition.

‘But it is not only about handing a patient a pack and sending them home. Nurses play a pivotal role in supporting patients in self-management. It’s about being there from the start to help patients reclaim their lives and slow down the progression of their disease.’

Find out more

BLF self-management pack

NICE: Management of COPD in adults in primary and secondary care clinical guidance

NICE COPD quality standard

Chronic obstructive pulmonary disease part 1: smoking cessation Jones, D. Nursing Standard (April 2015)

Chronic obstructive pulmonary disease part 2: non-pharmacological therapy Jones, D. Nursing Standard (April 2015)

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