Chronic obstructive pulmonary disease (COPD) is a major global epidemic. It already is the fourth commonest cause of death in high income countries and is predicted to soon become the third commonest cause of death worldwide.
In the United Kingdom, the mortality from COPD in women now exceeds that from breast cancer. COPD is also predicted to become the fifth commonest cause of chronic disability, largely because of the increasing levels of cigarette smoking in developing countries in conjunction with an ageing population.
It now affects approximately 10% of men and women over 40 years in the United Kingdom and is one of the commonest causes of hospital admission.
Because of this, COPD has an increasing economic impact, and direct healthcare costs now exceed those of asthma by more than threefold. Despite these startling statistics, COPD has been relatively neglected and is still underdiagnosed in primary care settings.
This is in marked contrast to asthma, which is now recognised and well managed in the community. The new NHS National Strategy seeks to improve diagnosis and management of COPD in the community and reduce hospital admissions.
Highly effective treatment is now available for asthma, which has in turn transformed patients’ lives. Sadly, this is not the case with COPD, where management is less effective and no drug has so far been shown to convincingly slow progression of the disease.
However, we do now have effective bronchodilators and non-pharmacological treatments, which can improve the quality of life of patients.
Many patients, however, are not diagnosed or undertreated, so increased awareness of COPD is needed.
There are advances in understanding the underlying inflammatory disease, so this may lead to more effective use of existing treatment and the development of new drugs in the future.
In this second edition of the ABC COPD monograph, Graeme Currie and colleagues provide a timely update on the pathophysiology, diagnosis, and modern management of COPD.
It is vital that COPD is recognized and treated appropriately in general practice where the majority of patients are managed, and this book provides a straightforward overview of the key issues relating to this important condition.
