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GPs urged to fight 'nihilistic' hospital doctors over COPD

GPs must counter the ‘nihilistic' approach of hospital doctors towards patients with severe COPD, say respiratory GPs and specialists.

The comments follow a UK study suggesting hospital doctors are overly pessimistic about patients admitted with COPD exacerbations, and may deny them emergency care.

Hospital doctors predicted that 49% of 832 patients would survive, but the actual figures showed that 62% lived to 180 days.

This pessimism means too many COPD patients being excluded from intensive care or respiratory high dependency units.

Dr Martin Wildman, lead author and consultant chest physician at Northern General Hospital in Sheffield, said there was a ‘nihilistic' approach to severe COPD and recommended GPs act as advocates for patients in their referral letters.

‘If the GP sent them in with a very strongly supporting letter, then that might an effect on altering that pessimism,' he said.

Dr Noel O'Kelly, a GPSI in COPD at Lincolnshire PCT agreed GPs could provide the ‘whole picture' of a patient in a referral letter. But he added that many COPD patients were emergency admissions to hospital.

The research was published early online in the BMJ.

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