Tackling the burden of COPD
Chronic Obstructive Pulmonary Disease Can you imagine not being able to carry out simple daily activities such as walking to the shops, getting dressed or climbing the stairs, without getting breathless? This is how patients living with chronic obstructive pulmonary disease (COPD) have described their lifestyle.
COPD is a long-term condition with inflammation in the lungs, damaged lung tissue and a narrowing of the airways, making breathing difficult. Despite this condition having a huge individual and societal burden, there are still an alarming number of people who have not heard of the term COPD.
As World COPD Day is marked across the world, it provides a key opportunity to raise awareness of COPD, which affects up to 20 per cent of the adult population in Europe. This figure is also expected to rise in industrialised and developing countries in the decades to come.
The biggest risk factor for COPD is smoking and 40-50 per cent of lifelong smokers will develop COPD. The European Respiratory Society (ERS) and European Lung Foundation (ELF), along with other health stakeholders, have been committed in recent years to tackling the smoking epidemic and significant steps have been made. Nicotine dependence is one of the most serious addictions that exists and strategies must be intensified to target education around this in schools before young people develop this addiction.
Lifestyle factors such as exposure to high levels of air pollution, damp indoors and a poor diet have all been linked with COPD. These factors are often related to features of lower socio-economic status, which has to be tackled on a global scale. However, it is also down to healthcare providers to look at these individual factors in each patient’s lifestyle and to address these.
If we are to be successful in reducing the number of people suffering from COPD, we have to raise awareness and knowledge of the condition and how to help prevent it. It is important to pay attention to your lung health throughout your life. The ERS and ELF Healthy Lungs for Life campaign aims to educate about how we can prevent all types of lung disease.
The theme for this year’s Healthy Lungs for Life campaign is ‘Take the active option’ aiming to raise awareness of the importance of physical activity for lung health. Regular physical activity has been shown to improve quality of life and fitness in healthy individuals and to reduce the risk of chronic disease. In addition, for COPD patients, physical activity can delay the onset or reduce the progression of the disease and reduce its severity.
Alongside medications for COPD, pulmonary rehabilitation should be offered to patients. This is a short course of regular exercises and educational sessions aimed at reducing the severity of symptoms and increasing a patient’s ability to participate in everyday activities. This programme is a key component of treatment for COPD and it can improve the effectiveness of long-acting bronchodilators when the two therapies are prescribed together.
Another key area of focus should be on research into COPD. A recent editorial in the journal Thorax highlighted the lack of funding for respiratory research in the UK. The total amount spent on funding between 2012 and 2015 from government agencies and national charities was approximately £96 million. As a comparison with another disease area, one charity (the British Heart Foundation) spent £115 million alone on research in one year (2013-2014). This is a particular problem for the field of COPD as more research is needed on current prevention, education, medication, treatment and care to drive higher standards across Europe. In addition, COPD can vary from person to person and we must have more in-depth studies to help understand these variations of the disease to understand the best way to manage the condition in different people.
Part of the problem causing a lack of funding in the field is the broad spectrum of respiratory diseases. This means that the community working to generate funding can be quite fragmented, spanning from stakeholders working in infectious medicine, to intensive care to oncology. We must strengthen alliances between these professionals and improve collaborative working between all stakeholders, to make some strides to delivering more high quality research.
Using the impetus of campaigns, such as World COPD Day and Healthy Lungs for Life, the respiratory community of professionals, patients and politicians, must work together to reduce the high burden of COPD in Europe.
 Thorax 2015;70:1011-1013 doi:10.1136/thoraxjnl-2015-207509