Chronic obstructive pulmonary disease
What is Chronic Obstructive Pulmonary disease? | How common is it it? | How is it managed? | What will the Chronic Disease Management Program do for people with this disease?What is Chronic Obstructive Pulmonary disease?
Chronic obstructive pulmonary disease (COPD) is a serious, long-term respiratory disease that mainly affects older people who have been exposed to tobacco smoke. It is characterised by persistent and irreversible airflow obstruction. People with this illness experience progressive shortness of breath on exertion. In most cases this is due destruction of the lung air sacs (emphysema) and scarring of the small airways.
How common is it it?
It is estimated that 2.9% of the Australian population have COPD with slightly more than half of cases occurring in females. It is most common among older people and also Indigenous Australians. COPD was the sixth leading cause of death in males and the seventh in females in Australia in 2005. Those dying or hospitalised with COPD are more likely than those without COPD to have other smoking related illnesses, such as lung cancer.
In NSW, in 2006-07, there were 17,765 hospital separations for COPD. Among people aged over 65 years, there were 1460 hospitalisations per 100,000 persons in NSW for COPD. In the same year there were 1581 deaths in NSW where COPD was the underlying cause.
How is it managed?
The regular use of a category of drugs called inhaled corticosteroids are now widely recommended for the management and control of COPD. These drugs have long been shown to be beneficial for people with asthma and have also been found to prevent COPD exacerbations (episodes where COPD becomes worse and/or life threatening) and deaths. Exacerbations are the most likely cause of hospitalisations in which COPD is the principal diagnosis.
People with severe COPD may additionally be managed with ambulatory oxygen therapy and bronchodilating medications. Smoking cessation advice is also an important element of the medical management of patients with COPD who continue to smoke. Notwithstanding that there are health benefits from smoking cessation for all smokers. There is evidence that self management can be beneficial for people with COPD which is a key component of the chronic disease management program.
What will the Chronic Disease Management Program do for people with this disease?
The Chronic Disease Management Program will identify people aged over 65 years (or if Aboriginal, aged over 45 years) who have three or more hospitalisations in a year where COPD is implicated. Those identified will be offered enrolment onto the program to receive Chronic Disease Management through a coordinated multidisciplinary approach including a shared care plan and 24 hour health coaching to promote self management. Previous trials and evidence based reviews have found that people with COPD benefit from coordinated care and disease management approaches.