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Optimising therapy in asthma and COPD

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Asthma and COPD are the two most commonly found obstructive lung conditions. The obstruction, which restricts airflow in and out of the lungs, is caused by narrowing of the airways. In asthma this narrowing is variable and reversible either spontaneously or with treatment, whereas in COPD the obstruction of airflow is fixed and progressively worsens. Both conditions feature inflammation as an underlying cause, but the type of inflammation differs so the treatment used to relieve or control symptoms is also very different. Treatment also reflects the underlying pathophysiology that leads to symptoms. Breathlessness and wheeze in asthma are related to the degree of bronchoconstriction in the lungs, which can vary depending on time of day and exposure to trigger factors. In COPD, symptoms of breathlessness and productive cough are related to chronic airway narrowing, damage to the mucociliary escalator and emphysematous changes causing air trapping within the peripheral lung fields. Therefore treatment to reduce morbidity aims to reduce the reaction to triggers in asthma, and releasing trapped air in COPD. In both conditions an overarching aim is to reduce the frequency and severity of exacerbations that pose an increased mortality risk.

This resource, which is based on typical case scenarios, is offered at an advanced level and includes five assessment questions to support your continuing professional development. Complete the module, including the recommended reading and some or all of the suggested activities, to obtain a certificate for one hour of continuing professional development to include in your annual portfolio.

Aims and objectives

On completion of this resource you should have an understanding of how to use a range of tools and treatments to:

  • Assess asthma control and relate this to a stepwise approach to treatment
  • Reduce disability and maintain quality of life in COPD using a holistic approach
  • Assess the risk and minimise the impact of acute exacerbations
  • Clearly identify the different pharmacological approaches to managing asthma and COPD
  • Consider appropriate non-pharmacological interventions for patients with COPD to reduce the burden of disease

Recommended Reading

The British Thoracic Society/Scottish Intercollegiate Guidelines Network, British Guideline on the Management of Asthma, 2014 update. Quick Reference Guide 141

http://www.sign.ac.uk/pdf/QRG141.pdf

Royal College of Physicians. Why Asthma Still Kills: National Review of Asthma Deaths (NRAD), 2014 Available at http://www.rcplondon.ac.uk/sites/default/files/why_asthma_still_kills_executive_summary.pdf

Department of Health. An outcomes strategy for people with chronic obstructive pulmonary disease (COPD) and asthma in England, 2011

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/216139/dh_128428.pdf

NICE CG101 Chronic obstructive pulmonary disease, 2010 https://www.nice.org.uk/guidance/cg101

Further education and training

Treatment and management of asthma and COPD is included as part of all asthma and COPD diploma and degree level courses in addition to one day workshops provided by Education for Health. For further information please see:

Asthma eLearning Degree Module 

COPD eLearning Degree Module 

Asthma eLearning Diploma Module 

Asthma eLearning Diploma Module (Stirling)

Asthma eLearning Diploma Module (London)

COPD eLearning Diploma Module

COPD eLearning Diploma Module (Stirling)

Essentials of Asthma Workshop

Essentials of COPD Workshop

Paediatric Asthma Workshop