UK COPD treatment: failing to progress

Abstract

Chronic obstructive pulmonary disease (COPD) is a major cause of mortality in the world today. More than a million British people lived with diagnosed COPD in the UK in 2014–15, or just under 2% of the population. COPD admissions to emergency services in the UK are on the rise, but, access to treatments shown to reduce patients' time spent in hospital is still woefully inadequate. Pulmonary rehabilitation, a treatment combining an exercise regimen and education about self-care, is widely acknowledged as an effective and high-value intervention for people with COPD, improving the patient's dyspnoea, exercise tolerance, and health-related quality of life. According to three new reports released by the Royal College of Physicians, published on April 12, only 60% of people living with COPD in England and Wales were enrolled into a pulmonary rehabilitation programme within 90 days of referral, and 38% of those did not complete the treatment course once assessed. Moreover, although 46% of hospitals report that pulmonary rehabilitation was available to patients within 4 weeks of discharge from hospital, over half of patients are still waiting longer than a month to receive this treatment. The report also shows that only 54% of hospitals provide smoking cessation services (compared with 63% in 2014), even though smoking cessation is known to decrease mortality in patients with COPD by slowing the decline in lung function over time and by limiting exacerbations The British Lung Foundation estimates that COPD costs the National Health Service (NHS) £1·9 billion each year, representing a major burden. Integrating services for better referral of COPD patients and facilitating access to pulmonary rehabilitation and smoking services will not only improve quality of life, but also relieve a growing burden on emergency services in the UK. Patient education is key. The NHS must do better to provide easier access to these services. Chronic obstructive pulmonary diseaseChronic obstructive pulmonary disease (COPD) kills more than 3 million people worldwide every year. Despite progress in the treatment of symptoms and prevention of acute exacerbations, few advances have been made to ameliorate disease progression or affect mortality. A better understanding of the complex disease mechanisms resulting in COPD is needed. Smoking cessation programmes, increasing physical activity, and early detection and treatment of comorbidities are further key components to reduce the burden of the disease. Full-Text PDF