NICE update on chronic obstructive pulmonary disease aims to improve patient care
An estimated 3 million people in the UK suffer breathlessness, a long-term cough or other symptoms caused by chronic obstructive pulmonary disease (COPD). But only around 900,000 are ever diagnosed - and most people don't know they have the condition until they are in their fifties.
Yet early diagnosis could help many people enjoy a much better quality of life.
New NICE guidance makes a series of recommendations to ensure this happens - and that adults with COPD get the right treatment. It updates NICE's previous recommendations on the condition which were published in 2004.
COPD covers several lung conditions including chronic bronchitis and emphysema. It usually develops because of long-term damage to the lungs from breathing in a harmful substance such as cigarette smoke or chemical fumes.
Coughing up phlegm or catarrh or a lot of coughing, breathlessness or wheezing during cold weather are other symptoms of the condition.
Although it's not possible to cure COPD, it is possible to help people breathe more easily. Treatment can also reduce the number of ‘exacerbations' or times when the disease flares up - usually in the form of bad chest infections which can put people in hospital.
NICE recommends breathing tests to check how well the lungs work using a spirometer which measures the amount of air you can blow out. A blood test, a chest X-ray and other measures may also be used to rule out other causes of the symptoms.
If someone is diagnosed with COPD and they smoke, quitting the habit is essential - and NICE now advises doctors to offer medicines or nicotine replacement therapy (NRT) to help people who may find this difficult.
The updated guidance also recommends that people with COPD who have recently been in hospital should be offered pulmonary rehabilitation, a form of therapy involving exercise and diet.
In addition, health professionals are given clear advice on the use of different ‘inhaled therapies'.
Inhaled therapies are an important part of the treatment as they help keep the airways open and so make it easier to breathe. Health professionals, says NICE, should be prepared to discuss any possible side-effects with patients.
Michael Rudolf, Consultant Respiratory Physician at Ealing Hospital, London and Chair of NICE's Guideline Development Group, says the recommendations will improve identification of the condition and increase the choice of treatment offered. He pointed out that they are “based on the most up-to-date clinical and cost effectiveness evidence”.
John O'Reilly, Consultant Physician, Aintree University Hospital and Guideline Development Group Clinical Adviser, believes the recommendations will make a real difference to patients' quality of life.
“We hope this updated guideline will ensure that patients who have previously remained undiagnosed will now be diagnosed correctly using spirometry and be able to have access to the right treatment.”
‘Chronic obstructive pulmonary disease: management of chronic obstructive pulmonary disease in adults in primary and secondary care (partial update)' replaces original NICE recommendations published in 2004. It is available at www.nice.org.uk/guidance/CG101
For NICE advice on quitting smoking see ‘Smoking cessation services' available at www.nice.org.uk/guidance/PH10
This page was last updated: 05 July 2010