COPD and Asthma Community Pharmacy Health Promotion

1. COPD and AsthmaCommunity Pharmacy Health Promotion Jenny Foster Community COPD Specialist Nurse/Practice Nurse

2. COPD • Chronic • Obstructive • Pulmonary • Disease

3. Definition of COPD Chronic Obstructive Pulmonary Disease (COPD) is characterised by airflow obstruction. The airflow obstruction is usually progressive, not fully reversible and does not change markedly over several months. The disease is predominantly caused be smoking NICE (2004)

4. What is COPD?

5. A few facts • An estimated 3 million people in the UK live with COPD • An estimated 2 million of these people are not diagnosed • In England and Wales 1 person dies from COPD every 20 minutes • 25% of smokers will develop COPD

6. Who is at risk of COPD?

8. Signs and Symptoms of COPD • Chronic cough • Breathlessness on exertion • Regular sputum production • Frequent winter ‘bronchitis’ • wheeze

9. What to look out for • Smokers • Over 35 years of age • Over use of inhalers • Frequent chest infections

10. Diagnosis • History • Family history • History of asthma or respiratory disease • Allergies • Onset of symptoms • Occupational risk factors • Smoking history – 20 cigarettes daily for 20 years at risk (20 pack years)

11. Spirometry • Diagnosis of COPD is only confirmed by accurate spirometry

12. The Impact of COPD • Extreme breathlessness on exertion • Chronic often productive cough • Recurrent exacerbations (infections) • Social isolation • Depression • Panic and anxiety • Embarrassment and stigma • Frequent attendances hospital or GP • Medications (and side effects) • Fear

13. How it feels to have COPD

14. Treatment • Smoking cessation advice and support • Education of patient and carers • Inhalers • Nebulisers • Pulmonary Rehabilitation • Oxygen

15. Asthma A chronic inflammatory disorder of the airways … in susceptible individuals, inflammatory symptoms are usually associated with widespread but variable airflow obstruction and an increase in airway response to a variety of stimuli. Obstruction is often reversible, either spontaneously or with treatment.”

17. Signs and Symptoms of Asthma • Wheeze, SOB, chest tightness, cough. Tending to be: • Variable • Intermittent • Worse at night • Provoked by triggers including exercise

18. What to look out for • Frequent requests for inhalers • Over use of oral prednisolone (steroids) • Wheeze • Cough

19. Asthma Diagnosis • personal/family history of asthma or allergies(atopy) • Affects all age groups • history of worsening after aspirin/NSAID, blocker use • recognised triggers – pollens, dust, animals, exercise, viral infections, chemicals, irritants • pattern and severity of symptoms and exacerbations • Peak Flow

20. COPD or Asthma?

21. Treatment • Inhalers • Steroid • Bronchodilators • Allergen avoidance • Education

22. Chronic Causes of breathlessness • Heart Disease e.g. LVF, arrhythmias • Other lung diseases e.g. Bronchiectasis, fibrosis • Anaemia • Psychogenic e.g. anxiety • Thyroid disease • Obesity • Thromboembolic • Neromuscular

23. Other Causes of Coughs • Infection • Allergies • Foreign body • Post nasal drip • GORD/Acid reflux • Heart failure

24. Lung Cancer An uncontrolled growth of abnormal cells in one or both lungs • Cells: Unable to carry out normal cell functions Unable to develop into healthy tissue Able to form tumours/impede lung function

25. Risk Factors • Smoking • Second hand smoke • Genetics • Environmental factors • Radon • Asbestos • Air pollution • Radiation exposure • Industrial substances

26. Symptoms • Cough • Haemoptysis • Weight loss/loss of appetite • Shortness of breath • Recurrent lung problems • Increased sputum

27. Treatment • Dependent on type of cancer • Surgery • Chemotherapy • Radiotherapy • Palliative

28. Questions?