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Evidence of what works

Adults :: COPD :: Evidence of what works

National guidelines and strategies have been developed to inform the treatment and management of COPD, ensuring that services and interventions are based on up to date evidence. The guidelines include:


• An Outcomes Strategy for Chronic Obstructive Pulmonary Disease (COPD) and Asthma in England, Department of Health July 2011
• An Outcomes Strategy for COPD and Asthma: NHS Companion Document, NHS England May 2012
• Chronic obstructive pulmonary disease in over 16s: diagnosis and management NICE guidelines [CG101] June 2010
• Chronic obstructive pulmonary disease in adults NICE quality standards [QS10] July 2011

The Five Year Forward View (FYFV) provides guidance on the treatment and management of COPD as part of its objective to reduce premature mortality[1].

Services and interventions that have been shown to be effective include:

Prevention

Smoking is the leading cause of COPD. Reducing tobacco use, through intervention such as Stop Smoking Services and tobacco control initiatives, will help to prevent cases of COPD occurring.

Early Diagnosis

The earlier COPD is diagnosed the more quickly it can be treated to slow the decline in lung function. It is estimated that as many as 2 million undiagnosed cases of COPD exist nationally[2]. Finding these 'missing millions' through targeted case finding is likely to improve outcomes for COPD patients and reduce emergency hospital admissions. The FYFV reports that between 10% and 34% of emergency admissions for acute exacerbation of COPD are in people whose COPD is undiagnosed, suggesting that successful case-finding and management could reduce COPD emergency admissions by up to one third.

Management of COPD

Providing appropriate treatment and supporting patients to manage their condition will prevent the worsening of the disease, enabling people to carry out their usual daily activities for longer. Interventions should include supporting COPD patients to stop smoking and providing pulmonary rehabilitation services.

Supported discharge scheme piloted in Medway Hospital in 2015, was effective in reducing the length of stay from 8 to 4.8 days for patients with COPD exacerbations.

The FYFV provides comprehensive evidence-based guidance for the clinical management of COPD, with factsheets on Non-invasive ventilation (NIV); Home oxygen; controlled oxygen dosing, and pulmonary rehabilitation[3].


References

[1]   NHS England. Five Year Forward View NHS Shared Planning Guidance Planning 2014/15 Reduce premature mortality Respiratory disease
[2]   Shahab L, Jarvis M, Britton J, et al. Prevalence, diagnosis and relation to tobacco dependence of chronic obstructive pulmonary disease in a nationally representative population sample Thorax 2006; 61(12): 1043-1047.
[3]   NHS England. Overview of potential to reduce lives lost from Chronic Obstructive Pulmonary Disease (COPD) 2014;