Rescue packs for COPD: problem or panacea?
Exacerbations of COPD require additional acute treatment. Beverley Bostock discusses the rationale for offering rescue packs as part of patient self-management
For many people who have been diagnosed with COPD, there is a risk of experiencing an exacerbation of their symptoms which will require additional acute treatment to supplement their usual therapy. Exacerbations of COPD are associated with reduced quality of life, loss of lung function and a higher risk of dying. People living with COPD may be advised to keep a ‘rescue pack’ of oral corticosteroids and antibiotics to start if they develop symptoms of an exacerbation. Patient education should include advice on how to recognise exacerbations and when and how to treat them, with information about the effects and side-effects of any medication.
Chronic obstructive pulmonary disease (COPD) is a condition which is associated with symptoms of breathlessness, cough and sputum (National Institute for Health and Care Excellence (NICE), 2019a). For many people who have been diagnosed with COPD, there is also a risk of experiencing an exacerbation of their symptoms which will require additional acute treatment to supplement their usual therapy. In the spirit of supporting self-management, people living with COPD (PLWCOPD) may be advised to keep a ‘rescue pack’ of oral corticosteroids and antibiotics to start if they develop symptoms of an exacerbation. In this article, the rationale for offering rescue packs will be considered, along with recommendations relating to the management of acute exacerbations of COPD (AECOPD) and the use of rescue packs.
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AECOPD are defined as an acute worsening of the respiratory symptoms associated with COPD, including cough, breathlessness and sputum production and which require additional therapy (NICE, 2019a; Ritchie and Wedzicha, 2020; Global Initiative for Chronic Obstructive Lung Disease (GOLD), 2021: 31). Exacerbations are often caused by viral infections, most often the common cold, but also bacterial infections or environmental pollutants, and they confer a significant burden on PLWCOPD, their carers and healthcare resources (GOLD, 2021: 7). In a pathophysiological sense, AECOPD are linked to increased levels of inflammation, hyperinflation and gas trapping (GOLD, 2021: 15).
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