Chronic Obstructive Pulmonary Disease

“Chronic obstructive pulmonary disease” is an umbrella term used to describe progressive lung diseases which make it difficult to breathe, including emphysema and chronic bronchitis. COPD is a major health problem and a significant cause of premature death in the UK. In England it is the second highest cause of emergency admissions to hospital. COPD accounts for 30,000 deaths per year, 1.4 million general practitioner (GP) consultations, and one in eight emergency admissions—therefore one of the costliest inpatient conditions treated by the NHS, accounting for nearly 10% of all bed days (NICE 2011). Patients experiencing exacerbations commonly seek medical attention late, resulting in hospital admission (preventable if treated early).

The majority of routine COPD care management takes place in primary care, with the most cost-effective interventions being smoking cessation, flu immunisation and pulmonary rehabilitation (PR) (London Respiratory Team 2012).

Pulmonary rehabilitation is reported to be an effective intervention for COPD, with evidence of improvements in exercise capacity, health-related quality of life and dyspnoea (Lacasse et al. 2006). There is also evidence of reductions in length of hospital admissions (Griffith et al. 2000). It is recommended that rehabilitation should be considered at all stages of COPD when symptoms or disability is present (usually Medical Research Council dyspnoea grade 3).