Management of COPD in Primary and Secondary Care , livre ebook

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119 pages

English

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COPD is preventable and treatable, yet its low profile and late presentation means that many people are not diagnosed until the disease has progressed to a moderate or severe stage, where interventions are less effective. The education of all healthcare professionals is therefore essential in improving care for this patient group. It is not simply a disease of the airways; it also has cognitive and social aspects and if care is to be optimised it needs to be approached holistically. This book addresses a wide range of issues and includes a chapter on the patient s perspective, written by a patient, which gives useful insights. It merits a place in the healthcare library

Sujets

Médecine

Pulmonology

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Publié par	M&K Publishing
Date de parution	30 novembre 2007
Nombre de lectures	0
EAN13	9781907830280
Langue	English
Poids de l'ouvrage	1 Mo

Informations légales : prix de location à la page 0,0600€. Cette information est donnée uniquement à titre indicatif conformément à la législation en vigueur.

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The Management of COPD in Primary and Secondary Care
An introduction
Edited by Dave Lynes
Available from M&K online store:
Books can be ordered at: www.mkupdate.co.uk
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The Management of COPD in Primary and Secondary Care
Dave Lynes
ISBN: 978-19-07830-28-0
First published 2007
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without either the prior permission of the publishers or a licence permitting restricted copying in the United Kingdom issued by the Copyright Licensing Agency, 90 Tottenham Court Road, London, W1T 4LP. Permissions may be sought directly from M&K Publishing, phone: 01768 773030, fax: 01768 781099 or email: publishing@mkupdate.co.uk .
Any person who does any unauthorised act in relation to this publication may be liable to criminal prosecution and civil claims for damages.
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library.
Notice:
Clinical practice and medical knowledge constantly evolve. Standard safety precautions must be followed, but, as knowledge is broadened by research, changes in practice, treatment and drug therapy may become necessary or appropriate. Readers must check the most current product information provided by the manufacturer of each drug to be administered and verify the dosages and correct administration, as well as contraindications. It is the responsibility of the practitioner, utilising the experience and knowledge of the patient, to determine dosages and the best treatment for each individual patient. Any brands mentioned in this book are as examples only and are not endorsed by the publisher. Neither the publisher nor the authors assume any liability for any injury and/or damage to persons or property arising from this publication.
The Publisher
To contact M&K Publishing write to:
M&K Update Ltd The Old Bakery St. John's Street
Keswick Cumbria CA12 5AS
Tel: 01768 773030 Fax: 01768 781099
Email: publishing@mkupdate.co.uk
www.mkupdate.co.uk
Designed & typeset in 11pt Usherwood Book by Mary
Blood Printed in England by Reeds Ltd., Penrith
Contents
About the contributors
Foreword
Acknowledgements
1.  Introduction
2.  Pathological processes, aetiology and natural history Dave Lynes
3.  The patient's perspective Eric Brownrigg
4.  Assessment and diagnosis Karen Frankland and Dave Lynes
5.  Pharmacological management of chronic disease Jenny Sparrow
6.  Managing an exacerbation in primary care Pat Fairclough
7.  Management of respiratory failure caused by exacerbations Sue Meehan
8.  Smoking and smoking cessation Dave Burns
9.  Holistic issues Carol Kelly
10. Domiciliary oxygen therapy Dave Lynes
11. Pulmonary rehabilitation Carol Kelly
Index
About the contributors
Eric Brownrigg is a retired carpenter and teacher. Eric has assisted in the coordination of ‘Breathe Easy’ support groups and participates in various initiatives including research and Practice Development Unit accreditation.
Dave Burns RGN, BSc (Hons), MSc is National Training Manager at Respiratory Education UK and Senior Lecturer, Edge Hill University.
Pat Fairclough RGN, MSc is a lecturer at Respiratory Education UK and a Respiratory Nurse Specialist.
Karen Frankland RGN, RM is Short Course Manager, Respiratory Education UK
Carol Kelly BSc (Hons), PGDip, RGN is a Senior Lecturer at Edge Hill University and Respiratory Education UK. Carol was previously a Respiratory Nurse Specialist in Hertfordshire and Respiratory Ward Manager, Lecturer/Practitioner at Warrington Hospital in Cheshire.
Dave Lynes ENG, RGN, DPSN, BSc (Hons), PhD is Head of Education at Respiratory Education UK and Academic Lead, Edge Hill University.
Sue Meehan RGN, BSc (Hons) is a lecturer at Respiratory Education UK and was recently a Lecturer/Practitioner at Southport Spinal Injuries Centre.
Jenny Sparrow BPharm (Hons), MRPharmS, Dip Clin Pharm is a senior clinical pharmacist specialising in respiratory medicine at Aintree University Hospitals.
Foreword
Chronic obstructive pulmonary disease (COPD) is an enormous problem. It is estimated to be the sixth leading cause of death in the world and it also has a corresponding high morbidity.
This high prevalence means that it is important that healthcare professionals are able to diagnose and manage COPD. With the advent of new medications and interventions much more is now known about how to optimise treatment, and patients and their families are rightly entitled to have access to good quality care. The Healthcare Commission's 2006 report Clearing the Air indicated that, of people admitted to hospital with an acute exacerbation of COPD, an average of 15 per cent die within three months. There is also evidence to suggest that mortality in acute COPD is related to the availability of resources and specialist professionals, with mortality rates varying from nine per cent in some areas to 21 per cent in others, indicative of inequalities in care.
COPD is preventable and treatable, yet its low profile and late presentation means that many people are not diagnosed until the disease has progressed to a moderate or severe stage, where interventions are less effective. The education of all healthcare professionals is therefore essential in improving care for this patient group.
COPD is not simply a disease of the airways; it also has cognitive and social aspects and if care is to be optimised it needs to be approached holistically. This book addresses a wide range of issues and includes a chapter on the patient's perspective, written by a patient, which gives useful insights. It merits a place in the healthcare library.
Gill Hall
Chief Executive, Respiratory Education UK
Acknowledgements
I would like to thank my children – Andrew, Heather, Kate and Ann – for helping and encouraging me to develop a healthy learning environment at home, and my mother Eirlys for continual support during academic pursuit. I am also indebted to Anne Richards and Lynda Slater for their valuable reviews and to Gill Butler for assistance with images and layout. Finally, I would like to thank Respiratory Education UK for permission to use diagrams and images.
Chapter 1
Introduction
Dave Lynes

Chronic obstructive pulmonary disease (COPD) is one of the most common chronic diseases and it will soon be one of the five ‘leading’ diseases worldwide (GOLD, 2004). This may be because of increased smoking, especially in adolescents and women. Patients with COPD frequently consult primary care practitioners, and COPD is responsible for considerable use of hospital services. COPD is also a major cause of morbidity, because it can have a considerable impact on the lifestyle of patients and their families, causing reduced mobility, social isolation, depression and anxiety. Indeed when the impact of lung cancer and COPD have been compared by interviewing carers or patients (Edmonds et al ., 2001) it is clear that COPD patients are more likely to experience symptoms for longer than lung cancer patients, and have significantly worse limitations of activities of daily living, and physical, social and emotional functioning.
Many COPD patients also experience unique problems such as a sense of guilt due to smoking, and due to the impact that their disorder has on their family life (Robinson, 2005). Indeed interviews reveal that COPD has a big impact on informal carers and families (Seamark et al ., 2004). Carers can experience similar losses to those experienced by patients, such as loss of income, social interaction, family events and holidays. The strain on carers is clear and exacerbated by financial problems if the patient can no longer work. Many patients find themselves in a downward spiral of increasing social and economic isolation, boredom, depression and disability.
As chronic respiratory disorders affect mobility, social isolation is an important consideration. Approximately half of COPD patients leave their house less than once per month or never in the last year of their life (Elkington et al ., 2005). Patients often describe their loneliness and their frustration due to planned breaks, such as Christmas with families, being curtailed due to illness (Guthrie et al ., 2001).
Patients with COPD are also regularly depressed (Elkington et al ., 2004). When lung cancer and COPD patients were compared using Hospital Anxiety and Depression scale (HADs) scores, 90 per cent of patients with COPD suffered clinically-relevant anxiety or depression, compared to 52 per cent of patients with lung cancer.
Panic and anxiety are common, as are loss of personal liberty and dignity (Guthrie et al ., 2001; Robinson, 2005; Seamark et al ., 2004). It is important to remember that the panic and anxiety experienced in COPD can also contribute to breathlessness; indeed panic and anxiety can cause breathlessness even in the absence of respiratory disease. COPD patients have physical and psycholo