Home > Adults > Respiratory >

Chronic Obstructive Pulmonary Disease

Checked: 23-07-2023 by Vicky Ryan Next Review: 23-07-2024

Overview

For advice on management of COPD, including treatment of exacerbations and prescribing advice for issuing rescue packs, please refer to the BNSSG COPD Treatment Guidelines

The guidelines have been updated by the respiratory teams at NBT and UHBW. The new guidelines aim to move in line with the NICE [NG115] COPD guidelines with the addition of some further changes in light of significant evidence.

Please also see the Community Respiratory Service section for information on our Home Oxygen and Review Service (HOS-AR), advice and guidance for healthcare professionals and Pulmonary rehab as well as other community services.

GPs can also offer the myCOPD App during clinical reviews, if their practice has signed up to the Digital Champion Service - see the myCOPD App page of Remedy for further details.

Air pollution and Health in Primary Care

Please see the Remedy page on Air pollution and health.

Rescue Packs

Consider a rescue pack for patients with > 2 exacerbations per year or ≥ 1 hospital admission who can recognise symptoms and act appropriately on them. Further details are in the BNSSG COPD Treatment Guidelines.

Referral Guidance

Patients who are not suitable for community services or needing consultant input should be referred to secondary care respiratory clinics via e-referral.

For more immediate concerns then please consider the Respiratory Hot Clinic.

Smoking Cessation for Patients with COPD

Smoking is the main cause of COPD and of the 7,000 people who have been diagnosed with COPD in Bristol, approximately 2,240 (32%) of them continue to smoke (BLF, Commissioning Excellence in COPD, 2010). By helping them to quit, then Emergency Admissions for COPD could be reduced by 40% (Euphix 2009), with an average cost saving of £1, 576 (BLF-Commissioniong Excellence in COPD 2010).

Please see the Smoking Cessation page for advice on support to stop services in your local area

Lung Volume Reduction

Refer to information leaflet for the management of Emphysema with Lung Volume Reduction through bronchoscopy.

Inclusion Criteria:

FEV1 Less Than 50% Predicted
MRC Breathlessness >3
6 Minute Walk Distance - 100 metres – 450 metres
Stopped Smoking for 6 Months
Have Completed Pulmonary Rehabilitation Programme - or willing to do so

Exclusion Criteria:

Current Smokers
Sputum Producing Bronchiectasis
Significant Asthma Component
Suspected Lung Cancer (Lung Nodules)
Severe Co-Morbid Conditions

LVR Referral

Referral for Lung Volume Reduction should be made via e-referral

Information for Patients

Information is available to patients at each stage of their condition.

Please check the Guide for professionals to appropriate information and when to give this to patients.

Services to help with your respiratory condition - is a leaflet produced by BNSSG for patients with information regarding local resouces.

The British Lung Foundation website also has a range of patient support resources including:

Breathlessness: What to do if you often get out of breath.
How to stop smoking, It's never too late to quit
First steps to living with COPD
COPD patient passport: Walk 10 steps to the best COPD care
COPD Self -management plan

Inhaler prescribing information lists all available inhaler devices. This site lists all available devices however, prescribing should be in line with recommendations on the BNSSG Formulary

COPD Assessment Test (CAT) can be downloaded to give to patients and used to assess symptom severity.

Steroid Sick Day Rules

Adrenal crisis | Society for Endocrinology - Advice about managment of adrenal crisis. A NHS steroid card can also be downloaded from this site.

Efforts are made to ensure the accuracy and agreement of these guidelines, including any content uploaded, referred to or linked to from the system. However, BNSSG ICB cannot guarantee this. This guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer, in accordance with the mental capacity act, and informed by the summary of product characteristics of any drugs they are considering. Practitioners are required to perform their duties in accordance with the law and their regulators and nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.

Information provided through Remedy is continually updated so please be aware any printed copies may quickly become out of date.