The importance of treating exacerbations
For the three million people with COPD in the UK1, exacerbations are a common feature of the condition and have a significant impact on long-term prognosis.2 Patients typically experience between 2.5 and 3 exacerbations per year,3 contributing to lung damage and accelerating the inevitable decline in airways function and quality of life.1
Exacerbations account for 10% of all acute hospital admissions4 and, once hospitalised, the outlook for patients is poor:
It is therefore crucial that the onset of an exacerbation is recognised in order to initiate prompt and effective treatment.
Symptoms of an exacerbation6-8
- Increased cough
- Increased sputum volume
- Increased sputum purulence
- Worsening breathlessness
Impact of an exacerbation
- May take 2 months for the symptoms to return to baseline9
- Accelerates the rate of lung function decline and worsens prognosis3,8,10
- Accelerates decline in quality of life2,8,11
- Accounts for a significant proportion of total cost of managing COPD2,12
- Stang P, Lydick E, Silberman C, Kempel A, Keating ET. The prevalence of COPD: using smoking rates to estimate disease frequency in the general population. Chest. 2000; 117: 354-359
- Booker R. VITAL COPD: your essential reference for the management of chronic obstructive pulmonary disease in primary care. London: Class Publishing; 2005. p. 83
- Donaldson GC, Wedzicha JA. COPD exacerbations – 1: epidemiology. European Respiratory Journal. 2003; Dec 22(6): 931-936
- The British Thoratic Society. Audit shows care of patients with COPD not good enough. 9th February 2005. Available from: www.brit-thoracic.org.uk
- Groenewegen KH, Schols AMWJ, Wouters EFM. Mortality and mortality-related factors after hospitalisation for acute exacerbation of COPD. Chest. 2003:124:459-67
- Chronic obstructive pulmonary disease: national clinical guideline for management of chronic obstructive pulmonary disease in adults in primary and secondary care. Thorax. 2004; 59(1): 1-232
- Anthonisen NR, Manfreda J, Warren CP. Antibiotic therapy in exacerbations of chronic obstructive pulmonary disease. Ann Intern Med. 1987;106(2):196-204
- A General Practice Airways Group Publication Ref 1001, 2005, Edition1. A Guide for those working in primary care
- Guidelines in Action: A step-by-step plan to implement NICE guidance in your practice, June 2006
- Soler-Cataluña JJ, Martínez-García MÁ, Román Sánchez P, Salcedo E, Navarro M, Ochando R. Severe acute exacerbations and mortality in patients with chronic obstructive pulmonary disease. Thorax. 2005; Nov 60(11): 925-31
- Spencer S, Calverley PMA, Burge PS, Jones PW. Impact of preventing exacerbations on deterioration of health status in COPD. Eur Resp J. 2004; 23: 698-702
- Britton M. The burden of COPD in the UK: results from the Confronting COPD survey. Respir Med. 2003; 97(Suppl c):S71-S79
PMR – NOV – 2006 – 0241
