References
An overview of prescribing practice and non-pharmacological treatments in COPD
Abstract
Chronic obstructive pulmonary disease (COPD) is a common heterogenous disease with significant personal implications, responsible for substantial healthcare costs. The goal of treatment and management in COPD is manageme symptoms, and reduce risk and frequency of exacerbations and hospitilisation using a patient-centred approach. This article summarises the main current pharmaceutical and non-pharmaceutical management strategies in COPD, drawing on contemporaneous clinical guidelines and evidence, and highlights how emerging COPD endotypes and phenotypes are enhancing our understanding. An overview of inhaled medications, the mainstay of COPD treatment is discussed, as well as the significance of device selection related to personal and physical considerations. Acute and long-term treatment and the criteria for specialist referral and medical management in complex patients is also presented.
Chronic obstructive pulmonary disease (COPD) is a common heterogeneous lung disease characterised by persistent respiratory symptoms, including breathlessness, cough, phlegm and exacerbations (Global Strategy for Diagnosis, Management and Prevention of Chronic Obstructive Pulmonary Disease (GOLD), 2022). Symptoms are the result of airflow limitation and structural changes to the airways and alveoli, leading to chronic bronchitis/bronchiolitis and/or emphysema.
Direct exposure to tobacco smoke, noxious gases and air pollution are the main known causes of COPD in the UK. Furthermore, abnormal lung development, genetic factors and early life lung insults, including social determinants of health, are linked to increasing risk and development of COPD (Soriano et al, 2018; Lee et al, 2022).
The healthcare burden of COPD in the UK is substantial, with an estimated cost to the NHS of £1.8 billion per annum (Trueman et al, 2017). Approximately 1.2 million people are diagnosed with COPD in the UK and it is the second most common lung disease after asthma. In addition, it is the fourth and fifth most common cause of death for men and women respectively, and the UK has the third-highest mortality rate for COPD in the whole of Europe (Trueman et al, 2017).
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