This guidance is for the care and treatment of people with chronic obstructive pulmonary disease. It explains guidance from NICE and is written for people with COPD but it may also be useful for their families or carers or for anyone with an interest in the condition.
What is COPD?
COPD is an incurable, chronic lung condition characterised by airflow obstruction that is not fully reversible and the condition is usually progressive. Smoking is a major cause but other factors may include occupational exposures to irritant inhalants such as diesel fumes, coal dust and some chemicals. Patients may experience exacerbations of their condition where symptoms become worse than usual and this sometimes requires hospital admission.
How common is it?
NICE says there are around 3 million people with COPD in the UK. About 900,000 have been diagnosed and approximately 2 million are undiagnosed.
How is it diagnosed?
Diagnosis relies on clinical judgement based on patient history, physical examination and spirometry.
Principles of management
- Patient should be encouraged to stop smoking
- Inhaled therapies should be prescribed according to NICE guidance. The aim is to reduce exacerbations and improve control of the disease.
- Inhaler technique should be checked regularly
- Pulmonary rehabilitation should be offered to all appropriate patients, including those who are functionally disabled by COPD and those who have recently been hospitalised for an acute exacerbation.
- Patients should be given self-management advice so they can respond promptly when they have signs of deterioration.
- COPD care should be delivered by a multidisciplinary team.
- Patients should be routinely screening for anxiety and depression as the condition has a significant effect on quality of life
Nurses have an important role in:
- Holistic assessment, treatment and monitoring of patients with COPD;
- Health education and smoking cessation;
- Advising patients on self management;
- Providing palliative care.
See NICE guidance on COPD: https://www.nice.org.uk/guidance/cg101
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