Comment - We need specialist nurses to tackle COPD

Eileen Shepherd

DipN, editor Respiratory Journal

Simple health promotion interventions that encourage smoking cessation can have an enormous impact on health outcomes for people with COPD. A recent study in Poland demonstrated that if patients are informed when lung function tests show they have signs of airway obstruction and are then provided with smoking cessation advice, a significant number give up smoking (Bednarek et al, 2006) (see Update, p40).

Simple health promotion interventions that encourage smoking cessation can have an enormous impact on health outcomes for people with COPD. A recent study in Poland demonstrated that if patients are informed when lung function tests show they have signs of airway obstruction and are then provided with smoking cessation advice, a significant number give up smoking (Bednarek et al, 2006) (see Update, p40).

However, a British Lung Foundation survey (2006) suggests that people with COPD in the UK are not receiving the help they need to stop smoking. A third of respondents said that their GP did not explain that the progression of their disease could slow down if they stopped smoking. Alarmingly, some respondents delayed seeking help from their GP for up to 10 years after they first noticed symptoms of COPD.

This survey demonstrates that smokers need to be targeted for lung function assessment and health promotion. So it is unfortunate that recent research in Manchester suggests spirometry is underused in general practice, leading to an underestimation of the number of people with COPD (Frank et al, 2006).

Nurses in primary care have a very important role to play in identifying smokers and explaining the risks of smoking to them and the health benefits of giving up. But we also need sufficient numbers of appropriately trained health professionals to carry out spirometry and interpret the results.

Even though this skilled nursing workforce is essential to support patients with chronic lung disease, the Association of Respiratory Nurse Specialists has reported that a number of respiratory
nurse posts are under threat across the country (see Update, p40). These specialists also provide valuable education and support
to general nurses in managing the secondary prevention of smoking-related disease.

Clearly, much more could be done to reduce the burden of COPD through the education of both healthcare professionals and patients. Respiratory nurse specialists are a fundamantal part of this process.