Supporting patients with COPD

Assessing adherence and improving inhaler technique, together with correct and optimal treatment in line with disease severity, will help with improving respiratory symptoms, slow lung function decline and reduce the risk of exacerbations.

NICE and GOLD agree that non-pharmacological approaches are key to successful COPD management and they list three priorities that achieve the best outcomes for a patient at the lowest possible cost to the NHS: 

1. Treating tobacco dependence

Very Brief Advice (VBA) on smoking is the key intervention community pharmacy teams can make. Approximately 40 per cent of people currently diagnosed with COPD are smokers. Smoking not only damages the lungs but also weakens the immune system and increases other health risk factors. This makes it more likely that smokers will get complications and take longer to recover from illness. 

Opportunities to use VBA include when someone comes to the pharmacy to collect a prescription for inhalers or asks for over-the-counter cough mixtures. Pharmacy teams can easily raise the issue by asking if a patient smokes or lives with a smoker. If the patient wants to know why they are being asked this, pharmacy team members can point out that smoking can affect lung conditions and explain that “because you have some inhalers, we just wanted to highlight that support and treatment is available on the NHS”.

2. Patients staying active regardless of COPD severity

Physical activity is now recommended for all patients with COPD. Exercising within their limits will help patients with breathlessness and help to strengthen muscles.

3. Receiving the key vaccines 

Vaccination is a key element of preventing illness and death in patients with COPD. Community pharmacy teams are in a unique position to encourage patients to have their vaccinations. 

• Influenza vaccine: vaccinations in people living with lung disease can reduce hospital admissions for flu by up to 52 per cent and mortality by 70 per cent, but uptake in people with chronic respiratory conditions is still low and leaves many people with lung disease at risk of complications associated with the flu
• Pneumococcal vaccine: pneumococcal infections are caused by the bacterium Streptococcus pneumoniae and can lead to pneumonia, septicaemia and meningitis. People with a long-term health condition like COPD may need a one-off pneumococcal vaccination or vaccination every five years, depending on their underlying health problem and irrespective of age
• Covid-19 vaccine: clinical ‘at risk’ groups for the Covid-19 vaccine are defined as “those with asthma that requires continuous or repeated use of systemic steroids or with previous exacerbations requiring hospital admission, and chronic obstructive pulmonary disease including chronic bronchitis and emphysema”.