Dealing with COPD in 10 minutes
From Dr Irem Patel PhD FRCP, consultant respiratory physician, integrated care, Kings Health Partners
Today, on World COPD Day (16 November) the British Lung Foundation is highlighting the millions of people across the UK who have this life-limiting lung condition, and don’t even know it
The charity is using the day to encourage everyone to take lung health seriously and healthcare professionals have a big part to play in this.
We recognise the immense time pressures primary care is under. In the context of a 10-minute consultation, what simple steps can you take to make a difference to your patients’ lung health? Early timely diagnosis and treatment is always better and cheaper than the alternative. So the next time you see a patient over 35 who is a current or ex-smoker and has respiratory symptoms such as shortness of breath, cough, sputum, wheeze or winter bronchitis, consider this as an opportunity to make a diagnosis of COPD. Remember to ask about tobacco but also cannabis, shisha and opiate smoking, and to offer advice and treatment.
Doing a quick micro-spirometry to get an FEV1 could be the first step, and will highlight those patients with possible airways disease. You then need to arrange quality assured spirometry. This means a post bronchodilator test on a calibrated spirometer which gives you a flow volume curve.
You could also consider arranging spirometry for your ‘asthma’ coded population over 40 who smoke - many COPD patients are historically miscoded as asthma.
You could also consider reviewing the patients on your mental health and substance misuse registers. These people have a high smoking prevalence, can be hard to reach, but die 20 years prematurely due to smoking related cardiorespiratory disease. The first step to breaking this cycle is to make the diagnosis with quality assured spirometry.
COPD is preventable and treatable. By identifying COPD early, we can offer highly effective evidence-based treatments for tobacco dependence and airways disease, to keep our patients healthy, active and independent in the long term.
The British Lung Foundation is encouraging anyone who gets out of breath doing everyday tasks, such as walking upstairs, to take their lung health seriously. The charity has set up a simple online breath test on its website and wants people to take the test and if advised to, seek advice from their GP. Healthcare professionals need to be prepared for these patients, in order to ensure correct diagnosis.
World COPD Day will raise awareness of this life-limiting condition. We must ensure that patients worried about their lung health get the support and timely diagnosis they need. For more guidance see here.