Approaches to COPD

When I say I work on Chronic Obstructive Pulmonary Disease (COPD), I usually get one out of two responses: sage nodding or confused smiles. Invariably, the nodders are those who know someone with COPD or work within the field. If you have ever seen anyone suffer from the disease, you’ll remember it. But if you have never encountered COPD directly, you’d be forgiven for not knowing too much about it. It has a low profile compared to diseases of similar impact. Unfairly so.

By way of background, chronic respiratory disease kills almost as many people as lung cancer in England and Wales each year, with the total annual toll being approximately 29,000. COPD makes up a large part of these numbers. The WHO estimates that COPD will be the third leading cause of death worldwide in 2030. Those numbers alone should warrant attention.

copd_deaths

In the UK, COPD is predominantly caused by smoking. The British Lung Foundation states that 80% of all cases are caused by long-term cigarette smoking, and that about 25% of all long-term smokers will develop the disease. Therein lies perhaps part of the problem with the public profile of COPD. There’s a disproportionate amount of blame to go around in ‘self-inflicted’ lung diseases, COPD included. This stigma is a barrier both to resource allocation (treatment availability, research funding) and to patients (treatment seeking behaviour), and contributes to making COPD a greater problem than it needs to be. Smoking cessation is important, but if we truly want to improve outcomes in COPD, we must let go of the moralising and focus on the medicine.

copd_cause

Furthermore, COPD is typically diagnosed late, its primary symptoms often confused for signs of aging or smoker’s cough. The treatment that many patients receive is too little too late. While it is not curable, it can be treated, and the effectiveness of treatment depends on early diagnosis. Increasing the profile of COPD, both with the public and healthcare professionals, is a way to remedy this.

I’ll let Mr Spock have the last word, as is appropriate:

nimoy(Leonard Nimoy, 1931-2015)