Optimising chronic obstructive pulmonary disease care: an overview for the community nurse

Chronic obstructive pulmonary disease (COPD) refers to a group of diseases that includes chronic bronchitis and emphysema, which is caused by damage to the airways or other parts of the lung. This blocks airflow and eventually makes it difficult for the patient to breathe. COPD is associated with structural lung changes owing to chronic inflammation from prolonged exposure to noxious particles or gases, most commonly cigarette smoke, and often presents with symptoms of cough, dyspnoea and sputum (phlegm or mucus) production (Agarwal et al, 2024). Chronic inflammation causes airway narrowing and decreased lung recoil, which refers to the lung's intrinsic tendency to deflate following inflation; the inability to fully exhale will gradually cause elevations in carbon dioxide levels and lead to oxygen deprivation (Agarwal et al, 2024).

There is currently no cure for COPD, which is characterised as a terminal condition. COPD is listed as the third leading cause of death and the seventh leading cause of poor health worldwide by the World Health Organization (WHO) (2023), causing 3.23 million deaths in 2019. Unlike many other common chronic conditions, the prevalence of COPD has not declined in recent years. In the UK, COPD is recorded as the second largest cause of emergency admissions; it has been reported to affect approximately 3 million people, with 2 million of these being undiagnosed, and accounts for around 1.4 million GP consultations per year (National Institute for Health and Care Excellence, 2023).