COPD 2024 (1) PDF

INTRODUCTION TO CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) OBJECTIVES At the end of this session students will be able to: Explain COPD in patient-appropriate language Describe the burden of COPD in Australia Describe the risk factors, diagnosis and clinical presentation of COPD Ou...

INTRODUCTION TO CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) OBJECTIVES At the end of this session students will be able to: Explain COPD in patient-appropriate language Describe the burden of COPD in Australia Describe the risk factors, diagnosis and clinical presentation of COPD Outline the Australian guidelines for the management of COPD DEFINITION COPD is a preventable and treatable lung disease characterised by chronic obstruction of the airways that is not fully reversible. DEFINITION COPD is a preventable and treatable lung disease characterised by chronic obstruction of the airways that is not fully reversible. Chronic – ongoing DEFINITION COPD is a preventable and treatable lung disease characterised by chronic obstruction of the airways that is not fully reversible. Chronic – ongoing Obstructive – airways narrowing DEFINITION COPD is a preventable and treatable lung disease characterised by chronic obstruction of the airways that is not fully reversible. Chronic – ongoing Obstructive – airways narrowing Pulmonary – lung DEFINITION COPD is a preventable and treatable lung disease characterised by chronic obstruction of the airways that is not fully reversible. Chronic – ongoing Obstructive – airways narrowing Pulmonary – lung Disease – disorder/illness DIAGNOSIS Spirometry – FEV1:FVC > 0.7 FEV1 (forced expiratory volume in 1 second) FVC (forced vital capacity) DIAGNOSIS Spirometry – PREVALENCE AND BURDEN Around 10% of First Nations people aged over 45-years are estimated to be living with COPD. Around 638,000 (2.5%) people in Australia were estimated to be living with COPD in 2022. COPD accounts for 3.6% of total burden of disease in Australia (205,000 DALY in 2023) PREVALENCE AND BURDEN In 2020-2021, there was an estimated $831.6million spent on the treatment and management of COPD in Australia In 2022, COPD was the underlying cause of death in 4.0% of all Australian adults. PRESENTATION - RISK FACTORS Smoking Exposure to irritants (environmental) Genetics Parental smoking Asthma PRESENTATION - RISK FACTORS Smoking Exposure to irritants (environmental) Genetics Parental smoking Asthma PRESENTATION - SYMPTOMS Progressive loss of lung function that is irreversible Progressive loss of physical activity capacity Symptoms include cough, sputum production, and dyspnoea (shortness of breath). Shares common symptoms with other lung conditions (asthma, bronchiectasis) and can co-occur. PRESENTATION - SYMPTOMS MANAGEMENT PRINCIPLES MANAGEMENT PRINCIPLES C: Confirm the diagnosis Spirometry Breathlessness Cough Sputum Exacerbations MANAGEMENT PRINCIPLES O: Optimise function Physical Activity Minimise frailty Bronchodilators Manage comorbidities Lung volume reduction surgery MANAGEMENT PRINCIPLES P: Prevent deterioration Smoking cessation Immunisation – influenza, pneumococcal, covid O2 therapy Prophylactic antibiotics Palliative care MANAGEMENT PRINCIPLES D: Develop a care plan Individualised, self-management plan i.e., Good inhaler technique, Medication and exercise regimes Pulmonary rehabilitation Exacerbation action plan REFERENCES Adeloye, D., Song, P., Zhu, Y., et al. Global, regional, and national prevalence of, and risk factors for, chronic obstructive pulmonary disease (COPD) in 2019; a systematic review and modelling analysis. Lancet Respir Med. 2022. 10:447-458. https://doi.org/10/1016/s2213-2600(21)00511-7. Dabscheck, E., George, J., Hermann, K., McDonald, C.F., McDonald, V.M., McNamara, R., O’Brien, M., Smith, B., Zwar, N.A. and Yang, I.A. (2022), COPD-X Australian guidelines for the diagnosis and management of chronic obstructive pulmonary disease: 2022 update. Med J Aust, 217: 415-423. https://doi.org/10.5694/mja2.51708 Lange P, Ahmed E, Lahmar ZM, Martinez FJ, Bourdin A. Natural history and mechanisms of COPD. Respirology. 2021; 26: 298–321. https://doi.org/10.1111/resp.14007 https://www.who.int/news-room/fact-sheets/detail/chronic-obstructive-pulmonary-disease-(copd) https://www.aihw.gov.au/reports/chronic-respiratory-conditions/copd Lung Foundation, 2020 https://lungfoundation.com.au/resources/?user_category=32