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COPD – getting the best out of treatments

We are still some way off finding a cure for COPD, the umbrella term for several different lung conditions including chronic bronchitis and emphysema. These conditions feature different underlying mechanisms but have similar health effects.

In terms of curing the disease, one possibility is repairing damaged lung tissue or replacing it with working tissue.  Exciting work is being undertaken by scientists looking into stem cell therapy, where stem cells could be used to replace damaged parts of the lung, but their work is still at an early stage and there are lots of hurdles to overcome. Some people may be offered a lung transplant, but  this is not an option for everyone and the procedure is risky and may cause an issue with tissue rejection and infections.

In the meantime, we need to put the emphasis on prevention. The majority of COPD is smoking-related, so quitting or avoiding starting is clearly one of the most important steps to prevent COPD developing, and can make a huge difference to outcomes after diagnosis. Smoking cessation programmes can help people who are keen to quit. Having the flu vaccine every year is recommended for people with COPD since flu can cause life-threatening complications.

There are already some very effective treatments which can dramatically improve symptoms for patients who can access them. In particular, pulmonary rehabilitation, which is a 6-8 week programme of supervised exercise which help improve lung function and stamina.

Studies consistently show that pulmonary rehabilitation can dramatically improve quality of life, although it will not halt the disease process completely.  But many COPD patients do not have access to pulmonary rehabilitation, and a large number of those who start the programme fail to reach the end. We would like to see better provision of pulmonary rehabilitation around the country so that everyone who can benefit from it can access it. And we need to look at ways to make it easier for people to initiate pulmonary rehabilitation and persist with it.

One way to do this would be to look at ways that people could do the exercises at home, using day-to-day objects for weights instead of specific gym equipment. Getting to and from a fitness or pulmonary rehabilitation centre can be difficult to people with COPD so it is important to make sure that people can do it at home. Specialist technology could help people see how they are progressing, since exercises themselves do not always show an immediate benefit and may even cause discomfort at the beginning of the process. This technology could also be accessed by healthcare professionals who can monitor patients from afar.

Of course we want a cure for this disease, but we are also need to make sure that we get the full benefit of using the treatments we already have.

On World COPD Day, the British Lung Foundation is encouraging everyone to take their lung health seriously, to take its simple on-line breath test www.blf.org.uk/breathtest and to visit their GP, if advised.”

Ian Jarrold
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