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The level of need in the population

Adults :: COPD :: The level of need in the population

As at March 2016, the number of people with a COPD diagnosis in Medway was 5,368. This represents a prevalence of 1.82%. The prevalence for the whole of England is 1.85%[1].

Whilst mortality attributable to respiratory causes has declined (Figure 6), Figure 5 shows, that the prevalence of COPD has in fact increased in Medway and England since 2006.

Figure 5: Trends in COPD prevalence
Figure 5: Recent trends in COPD prevalence[1]

There is a strong consensus of opinion that COPD prevalence is higher than suggested by recorded diagnoses. Modelled estimates of COPD, using a model developed by Imperial College London, suggest that the true prevalence in Medway could be 2.78% among those aged 16 years and over. (as opposed to 1.8% recorded), which equates to 6,347 people with COPD (as opposed to 5,368 recorded).

This gap, often described as the “missing millions” when considered nationally, represents people with COPD who have not been diagnosed. These people may not be aware they have a condition that needs treatment and are therefore likely to experience poorer outcomes. Thus reducing the gap between estimated and recorded COPD is an important public health issue.

Based on these data, it is estimated that 85% of COPD cases in Medway have been detected. This compares to an estimated 63% of cases detected in England.

Based on an analysis non-elective hospital admissions for COPD using data available from Dr Foster[2], Medway has a similar admission rate to England adjusting for the age structure of the population.

COPD is the fifth leading cause of death in the UK, killing approximately 25,000 people in England and Wales every year[3]. Figure 6 shows a downward trend in mortality rates from respiratory diseases, to which COPD is a key contributor. This pattern has been observed in England overall, South England, and in Medway.

Figure 6: Trends in respiratory mortality
Figure 6: Recent trends in respiratory mortality (under 75)[4]

Overall, there is a downward trend in mortality attributed to respiratory conditions. Medway has a higher premature (under 75 years) mortality rate from respiratory diseases (40.2 per 100,000) compared to England (33.1 per 100,000).

Preventable mortality rates give an indication of the number of deaths that could potentially be avoided by the implementation of public health interventions. In Medway, 149 deaths from respiratory diseases could have been prevented in 2013-2015. The rate of respiratory disease deaths considered preventable in Medway (24.4 per 100,000) is significantly higher than the preventable mortality rate in England (18.1 per 100,000)[4].


[1]   NHS Digital. Quality and Outcomes Framework
[2]   Dr Foster Intelligence. Standardised Admission Ratios: Practice and Provider Monitor
[3]   Department of Health. An Outcomes Strategy for Chronic Obstructive Pulmonary Disease (COPD) and Asthma 2011;
[4]   Public Health England. PHOF: Respiratory disease mortality rates (under 75) 2013-15 2016;