COPD, exacerbation and self-management: a literature review
The incidence of COPD is rising in the UK. Paula Boyer looks at the evidence for the self-management of COPD and how this can help manage exacerbations
Chronic obstructive pulmonary disease (COPD) is being increasingly diagnosed in the UK, and is expected to continue to rise due to an ageing population with multiple co-morbidities and exposure to risk factors, such as cigarette smoke, noxious gases and air pollutants. The prevalence of this disease is high in areas of socioeconomic deprivation and among highly industrial areas. The use of self-management plans in COPD is recommended by the National Institute for Health and Care Excellence (NICE), to enable patients with this disease to be competent and confident in taking part in managing their own health condition and recognising signs and symptoms of an exacerbation. The aim of this article is to discuss self-management of COPD and the clinical guidance surrounding exacerbation of disease.
Chronic obstructive pulmonary disease (COPD) is the third leading cause of death in the world (World Health Organization (WHO), 2020), accounting for 6% of total deaths, followed by lower respiratory tract infections, which are the fourth leading cause of death and are associated with the highest communicable disease mortality rate in the world. Approximately 3 million people in the UK have been diagnosed with COPD (British Thoracic Society, (BTS) (2018)), although over 1 million people have yet to be diagnosed. The Global Initiative for Lung Disease (GOLD) (2021) has implied that this figure is also set to rise in the coming decades due to risk factor exposure and population ageing. The WHO (2020) estimated that 65 million people have moderate to severe COPD worldwide.
COPD is defined as a preventable, treatable disease of the airways that causes persistent respiratory symptoms and airflow obstruction and an abnormal inflammatory response to noxious gases and particles (GOLD, 2021). Boland et al (2012) expanded this definition, adding that it is a life-limiting illness that may cause a significant burden for patients and carers, with an increasing cost to the NHS. The British Lung Foundation (2017) estimated that COPD costs the NHS £1.9 billion each year.
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