CONCLUSION
COPD is one of the leading causes of death in the United States and worldwide, caused primarily by cigarette smoking. It leads to breathing difficulty even with mild exercise and during routine activities of daily living, eventually making it hard for the person with COPD to do anything more than sit or lie down.
Healthcare professionals can encourage and support all patients to stop smoking immediately as a form of prevention or, in those with COPD, to slow down the progression of the disease and improve their quality of life. COPD’s first symptom is typically coughing, although dyspnea is what usually first prompts someone to seek care.
COPD is a life-long disease, and treatment focuses both on long-term goals (slowing its progression, easing symptoms, improving quality of life, preventing acute exacerbations) and managing acute exacerbations. Therapeutic lifestyle changes are fundamental, and healthcare professionals can assist patients though education, supporting smoking cessation, and pulmonary rehabilitation programs. There is no cure, but pulmonary rehabilitation has been effective in improving COPD patients’ physical function and endurance. Patients may, at best, prolong the gradual decline in their ability to perform activities of daily living (ADLs) over the course of their remaining lifetime.
Primary care providers introduce drug therapy to reduce restrictions in a patient’s activities. Bronchodilators are used to relieve dyspnea and are typically administered via inhalers. Corticosteroids are also effective as anti-inflammatories, generally used in patients with severe COPD. Eventually, oxygen therapy may be required. Surgery (lung transplantation, lung volume reduction, and bullectomy) may be also recommended in cases of severe COPD that no longer respond to medication therapies.
There are special considerations for the COPD patient who is COVID-19 positive. While COPD patients are not found to be at greater risk for contracting the SARS-CoV-2 virus, once infected they are at greater risk for exacerbation of their chronic illness because their lungs are more fragile. It is therefore especially important that COPD patients follow COVID-19 prevention precautions. Some COPD treatments must also be altered in patients with COVID.
Because COPD is a chronic condition affecting millions of people, healthcare providers can provide effective care by helping their patients understand the disease, quit smoking in order to slow its progression, learn how to manage their long-term treatment, and prepare for and know what actions to take in the event of an acute exacerbation.
RESOURCES
Chronic obstructive pulmonary disease (COPD) (American Lung Association)
Chronic obstructive pulmonary disease (COPD) (Centers for Disease Control and Prevention)
COPD: Conserving your energy (Cleveland Clinic Foundation)
COPD clinical resources (American Thoracic Society)
Freedom from smoking (American Lung Association)
GOLD (Global Initiative for Chronic Obstructive Lung Disease)
What is COPD? (National Heart, Lung, and Blood Institute)
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NOTE: Complete URLs for references retrieved from online sources are provided in the PDF of this course.
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