I spent 12 years as a respiratory nurse and 20 years as an intensive care sister. Helping respiratory patients has always been important to me. Even now I’m retired, I help run a successful British Lung Foundation (BLF) integrated Breathe Easy support group as a volunteer.
Many of the Breathe Easy members in our support group have chronic obstructive pulmonary disease (COPD) – previously known as emphysema and chronic bronchitis. Unfortunately, many people throughout the UK have never heard of COPD even though it kills around 30,000 people every year, making it the country’s fifth biggest killer. It is a disease that can severely affect a person’s quality of life, leaving them breathless after doing simple things such as getting up in the morning or getting dressed.
However, COPD patients can live better, fuller lives through good self-management. That’s why the theme of this year’s World COPD Day (19 November), ‘Living with COPD’, is an important one. It is aboutencouraging patients to take control of their condition to live healthier, more active lives. It is also a reason the BLF has launched a ‘COPD Patient Passport’ (a counterpart to their ‘COPD patient pathway’ for healthcare professionals), to help patients discuss, understand and manage their condition better.
One of the most important parts of self-management is exercise, particularly as advised through pulmonary rehabilitation (PR) – a programme of exercise and education for people with long term chest problems. PR is a well-tested successful tool designed to help patients cope with breathlessness and feel stronger and fitter. Having seen first-hand the benefits PR can bring, I am a firm believer that it can make an incredible difference to someone living with COPD.
National Institute for Health and Care Excellence (NICE) guidelines on COPD say PR should be offered to every patient, particularly any patient admitted to hospital with an exacerbation. Many patients struggle with the constant breathlessness and so decide to cut back on exercise. However, this is counterproductive because without exercise, a patient becomes less fit and more tired and breathless over time. PR can help break this cycle.
PR improves measurements of health and wellbeing, such as the distance an individual can walk or their likelihood of needing to go to hospital. COPD is the second most common cause of emergency hospital admissions in the UK, with an estimated 94,000 admissions every year. It is one of the most costly inpatient conditions treated by the NHS. Referring more people to PR could not only reduce the number of hospital re-admissions, but also save the NHS money.
Unfortunately, while in some areas PR has been made available to a number of patients who previously did not have access to it, PR provision has also slipped between cracks in other areas following the NHS reforms, denying some patients local access. It is important that such regression does not become more widespread. Throughout my career I have witnessed just how important PR is as a part of self-management. It is key to empowering patients, and I hope that this is remembered this World COPD Day and into the future.