COPD Resources

Peak expiratory flow rate (PEFR) is the volume of air forcefully exhaled at maximum speed. This can be measured using a peak flow meter or a spirometry device. Peak flow meters are portable, inexpensive and widely available. The technique is non-invasive, carries no risk to the person, can be taught and learned quickly, and can easily be mastered by the patient. Published evidence for the use of peak expiratory flow rate (PEFR) and peak flow monitoring in asthma is limited, despite the use of the peak flow meter being documented in national and international guidelines for many years. National and international guidelines recommend the use of easily calibrated spirometers, which can provide accurate results
with good technique, along with fractional exhaled nitrous oxide (FeNO) testing, which requires a greater analysis and interpretation of the results. Is the use therefore of the peak flow meter redundant? This article discusses the indications for use of peak flow meters, technique and clinical context.

For many nurses working in general practice, chronic obstructive pulmonary disease (COPD) is a familiar condition. From carrying out annual reviews to supporting people living with the symptoms of cough, phlegm, breathlessness and managing their effect on day-to-day living, most general practice nurses (GPNs) will have some experience of supporting people living with COPD. Increasingly, though, GPNs are having to consider comorbidities as part of the review, as for many people living with COPD, this will be just one of the long-term conditions they have already been diagnosed with or of which they will be at risk. In this article, the relationship between COPD and other long-term conditions will be highlighted, along with recommendations about how to identify and manage comorbidities in order to holistically optimise outcomes.

This article focuses on the benefits of physical activity for people with a common long-term condition, chronic obstructive pulmonary disease (COPD). It highlights the evidence and explains the importance of both increasing physical activity and reducing sedentary time for health. The availability of brief interventions for physical activity in primary care vary widely and therefore this article offers some suggestions about how to close that gap and broach the subject in practice. It introduces some free new resources for people with COPD to support them to become more physically active.

Chronic obstructive pulmonary disease (COPD) is a term often used for two common incurable lung conditions, chronic bronchitis and emphysema. Breathlessness is the main symptom experienced by patients, which can be frightening and patients can develop symptoms of anxiety, panic, low mood and depression. General practice nurses (GPNs) are ideally placed to address these symptoms. This article describes the importance of considering psychological well-being to improve self-management in COPD and how cognitive behavioural therapy (CBT) techniques can be used to assess and manage the psychological impact of breathlessness. Addressing mental health is a key area to improve self-management in COPD and research has found that respiratory nurses were able to learn and deliver CBT techniques to patients with COPD and improve symptoms of anxiety and depression, as well as quality of life, while also reducing use of healthcare resources (Heslop-Marshall et al, 2018). GPNs can likewise improve self-management by incorporating CBT techniques.

None of the 13 million of us in the UK who watched the final of ‘Strictly Come Dancing’ 2020 will need convincing of the joy of dance and dancing with others — nor of the endurance, strength, flexibility and balance required. But, have you ever considered how dance can be used therapeutically? This article presents evidence and practice about the use of dance in chronic disease management, in particular, its role in alleviating breathlessness. One of the main causes of breathlessness is chronic obstructive pulmonary disease (COPD). Pulmonary rehabilitation (PR) is an effective treatment for COPD, including tailored exercise and education, but it is not available or suitable for everyone. There is potential for dance to be offered as a therapeutic intervention for people with COPD and other chronic respiratory diseases in several ways: by incorporation into existing programmes to increase the variety of exercise, post-PR as maintenance therapy, as an alternative for those who choose not to attend PR, and for those who are not offered PR.

Malnutrition is common in patients with chronic obstructive pulmonary disease (COPD), particularly as the disease progresses. This article looks at the nutritional issues facing patients with COPD, including the effects of medication, social and psychological issues. It outlines the role that general practice nurses (GPNs) can play by implementing the newly updated ‘Managing Malnutrition in COPD’ guidance. The guidance encourages incorporation of nutritional screening into COPD care pathways and the optimisation of nutritional intake for those at medium and high risk of malnutrition via dietary advice and oral nutritional supplementation, where appropriate. It also provides practical tips for patients with COPD to help manage common barriers to eating, such as shortness of breath, dry mouth and taste changes.

In December 2018, the National Institute for Health and Care Excellence (NICE) published new guidelines on the diagnosis and management of chronic obstructive pulmonary disease (COPD) in over 16s, which have subsequently been updated in July 2019 (NICE, 2019). Here, Jaqui Walker, advanced nurse practitioner/general practice nurse, Stirling, looks at what the 2019 changes are, how they are influencing practice, and gives handy tips on how to implement the key changes.

Nutrition is an important modifiable factor for patients with chronic obstructive pulmonary disease (COPD). Being overweight brings breathing difficulties and being malnourished leads to poorer outcomes. Maintaining a healthy weight and a nutritious diet is a central part of COPD management. This article equips general practice nurses (GPNs) and patients with the tools needed to assess and promote a healthy weight and diet while living with COPD. It explains the reasons for malnutrition and how these can be avoided. Helping people improve their diet as well as the role of oral nutritional supplements (ONS) are explored, and specific issues, such as vitamin D deficiency, are discussed.

Supporting patients with COPD to self-care. 

By 2030, chronic obstructive pulmonary disease (COPD) is projected to be the third leading cause of death worldwide (World Health Organization [WHO], 2016). Within the UK, it is estimated that around three million people are living with COPD in England alone, with two million of these unaware that they are living with the condition (Department of Health [DH], 2012).

It is the fifth biggest killer in the UK overall, causing about 30,000 deaths each year (DH, 2011). The condition itself is associated with considerable disability, impaired quality of life and high utilisation of healthcare resources.