Enhancing the diagnosis and management of COPD in Primary care

Excerpt

Achieving the optimal management of Chronic Obstructive Pulmonary Disease (COPD) is a major challenge facing all countries where smoking is and has been highly prevalent. The consequences of missed or delayed diagnosis represent a source of distress to patients, unnecessary expense to health care systems, and a missed opportunity to implement the many things we can now do to reduce the burden of this disease. Others have described the story of COPD as being a story with no beginning, a middle that is a way of life, and an unpredictable and unanticipated end [1]. If we are to give the story a beginning it can be achieved either by the recognition of symptoms leading to an accurate objective diagnosis, or less satisfactorily by a major event such as an exacerbation starting the story. In the latter case the opportunity for support with smoking cessation, pulmonary rehabilitation and initiation of guideline recommended therapies is missed. The immense value of flu vaccination, stop smoking support, pulmonary rehabilitation and simple bronchodilator therapy, compared to more complex therapies and interventions, has been graphically displayed in the Pyramid of value for COPD interventions to which further attention has been drawn recently [2]. So how do we start the story earlier to ensure that those with COPD are offered and take these cost effective interventions? …