There is evidence that there is a widespread lack of knowledge about COPD amongst the general public and healthcare professionals. There is also evidence that some healthcare professionals are unaware of the definition of COPD, do not use diagnostic measures well, and see COPD as a self-inflicted condition to which they give little sympathy [1,2,3,8].
Within the general public awareness of COPD is low, both in terms of what causes it, and the impact of having COPD. There needs to be more focus on raising awareness within the population, particularly in young people before they are exposed to some of the risk factors for COPD. This can be done through health promotion campaigns and the school curriculum.
There is evidence that patients with COPD are confused about the various disease labels that are used to describe COPD, are often unaware of the link between smoking and COPD, and do not realise that stopping smoking will reduce the rate of further decline in lung function [4].
It is important to focus on the early common signs of COPD; breathlessness, cough and spit, especially in current or past long-term smokers, or those who work in hazardous environments. Chronic cough is often the first symptom of COPD to develop. It is often ignored by people as a normal consequence of smoking or other exposures, for example dust at work. The cough may start as intermittent, eventually being there everyday, throughout the whole day [5].
Persistent and progressive breathlessness is a characteristic of COPD. COPD patients experience breathlessness at lower levels of exercise than unaffected people of the same age. At first, the breathlessness may only be noticed when doing strenuous exercise. This often leads to a change in behaviour so that strenuous exercise is avoided. As lung function deteriorates, breathlessness can become present during everyday activities (e.g., dressing, washing) or at rest [6].
People with COPD often produce small amounts of sputum or spit after coughing fits. Increased amounts over a long period of time may indicate a problem [8].
It is estimated that between 9% and 30% of patients are undiagnosed, despite having symptoms consistent with COPD [7]. By raising awareness of these symptoms and the link with COPD it is hoped that more people will seek professional help earlier, rather than modifying their behaviour to cope with the symptoms and therefore being more likely to present at a later stage of the disease. By raising awareness of these symptoms within the healthcare profession, it will also mean that COPD will be more likely to be considered as a possible diagnosis and the correct diagnostic tests offered. It is estimated that up to 65% of patients do not receive regular prescribed medication for their symptoms [16]. These issues need to be embedded into the core training for healthcare professionals.
There is no published evidence that evaluates targeting lung health rather than COPD per se. However, there is evidence that there is confusion over what COPD is, and to address this there should be more emphasis on lung health as a whole as this is more easily understandable, and will also have wider health benefits.
This is consistent with the approach that has been taken in other disease areas, for example coronary heart disease. The National Service Framework for coronary heart disease succeeded in uniting Government and clinical agendas to deliver improvements across the entire patient pathway. A national programme for improving heart health contributed to a reduction in mortality and significant improvements in care for patients with heart disease [8].
