COPD is a long-standing condition affecting the airways and the lungs. Global Initiative for Chronic Obstructive Lung Disease (GOLD) organizes World COPD day every year and November is observed as COPD awareness month. The aim is to raise awareness, share knowledge, and discuss ways to reduce the burden of COPD worldwide. This year world COPD day will be observed on 18th November 2020 and the theme for this year тАЬ LIVING WELL WITH COPD, EVERYBODY EVERYWHEREтАЭ
This yearтАЩs aim is to send a positive message to both patients and providers that although COPD does not have a cure, there are many ways to actively live well
Chronic obstructive pulmonary disease (COPD) is a common condition, which is preventable and treatable. It is characterized by persistent respiratory symptoms and airflow limitation resulting from airway and/or alveolar abnormalities usually caused by substantial exposure to noxious particles or gases
COPD is usually seen later in life, is insidious with productive cough with shortness of breath being its prominent symptom. The main risk factor for COPD is tobacco smoking. Other risk factors include Environmental exposures like biomass fuel exposure and Air pollution. Host factors like genetic abnormalities, abnormal lung development and accelerated ageing also contribute to COPD
COPD is currently the 3rd leading cause of death globally. COPD contributes to significant morbidity and mortality and also causes an economic burden to the society. Currently, with the COVID 19- pandemic, SARS COV 2 infected people with COPD have worse outcomes.
COPD should be considered in people presenting with long-standing cough often with sputum and with progressive breathing difficulty. Spirometry is required for the diagnosis of COPD. Chest imaging like X-ray, CT scan and cardiac evaluation will be required to rule out other causes and comorbidities.
Concomitant chronic disease occurs frequently with COPD like cardiovascular disease, Metabolic syndrome, Osteoporosis, Sleep apnea, Depression, Skeletal muscle dysfunction, anxiety and lung cancer. One should look carefully for associated conditions as this will significantly increase Hospitalizations and Mortality.
Pharmacological Treatment of COPD mainly includes using inhaled bronchodilators which are available in various forms. They are available as dry powder inhaler, Metered-dose inhaler and nebulised forms. Use of proper technique while using these devices is very important. Inhaler technique needs to be assessed regularly.
Treatment regimen should be individualized based on the severity of symptoms, associated comorbidities, Drug availability and costs, patient preferences and Response to treatment. Steroids, Mucolytics may help in some selected patients.
Smoking cessation remains the key in prevention and also limiting the progression of COPD. Pneumococcal and influenza vaccinations are advised to patients with COPD in order to prevent infections and to avoid exacerbation.
Supplemental long term Oxygen therapy needs to be given in selected patients which will improve survival. COPD Patients with symptomatic carbon dioxide retention will require Non-invasive ventilation which may decrease mortality and re-hospitalization. Surgical or Bronchoscopic interventions may help in selected patients.
Pulmonary rehabilitation will help improve symptoms, quality of life, and to get going with everyday activities. Depression and anxiety are common in COPD and can influence mortality and hospitalizations. In addition to mind-body techniques and cognitive therapy, pulmonary rehabilitation may also reduce anxiety and depression.
Nutritional supplementation may help in malnourished patients to improve respiratory muscle strength and overall health status.
Educating patients regarding the treatment, Identifying the exacerbation features, worsening of breathlessness, change in quantity and color of the sputum and to visit their doctor earlier can help reduce the hospitalization.
It is important for all of us to have the knowledge of COPD to help patients with COPD to control, manage and to live well with the disease
Dr. Arun H M, Consultant Pulmonology, Narayana Multispeciality Hospital, Mysore