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A GROWING CONCERN

An estimated 3 million people have Chronic Obstructive Pulmonary Disease (COPD) in the UK about 900,00 have diagnosed COPD and an estimated 2 million people have COPD which remains undiagnosed.1 It is the 5th biggest killer in the UK. It costs the NHS more than £800 million (equivalent to 1.3 million per 100,000 population) each year.2

COPD represents the biggest caseload for primary care, and the biggest single cause (12%) of emergency admissions.

Over 1 in 3 patients admitted to hospital with COPD will be readmitted within 30 days and 1 in 10 dies within that period. A key factor in managing patients with COPD is vital signs monitoring and avoidance of disease exacerbation.

COPD

WHAT IS COPD ?

COPD is a term used to describe a progressive and irreversible decline in lung function which results in reduced airflow in the lungs. It includes two main diseases

  • Chronic Bronchitis. Bronchitis is where inflammation narrows the bronchi (the tubes carrying air to and from the lungs) and causes chronic bronchial secretions.
  • Emphysema – a permanent destructive enlargement of the airspace within the lung without any accompanying fibrosis of the lung tissue.

Asthma may also be included within the term COPD if there is some degree of chronic airway obstruction.

Many people are not diagnosed in the early stages of the disease, as symptoms become manifest only at or beyond middle age (45 years).

COPD is characterised by airflow obstruction that is not fully reversible. The airflow obstruction does not change markedly over several months and is usually progressive in the long term. COPD predominantly caused by smoking. Other factors, particularly occupational exposures, may also contribute to the development of COPD. Exacerbation often occur, where there is a rapid and sustained worsening of symptoms beyond normal day to day variations.

References:

1.Healthcare commission(2006) Clearing the air: a national study of chrOnic obstructive pulmonary disease. London: Healthcare commission.
2. Long term conditions, DH Report

3. NICE (2004). Chronic obstructive pulmonary disease. NICE clinical guidelines on management of chronic obstructive pulmonary disease in adults in primary and secondary care. Thorax 59( suppli1):1-232.