Summary

Chronic obstructive pulmonary disease (COPD) is the name for a group of lung conditions that cause breathing difficulties. The main cause is smoking, but it can also be caused by long-term exposure to harmful dust, fumes and chemicals.

COPD includes two separate conditions (that often occur together):

• Emphysema is where the air sacs in your lungs become damaged.
• Bronchitis is where the airways are inflamed and narrowed.

With COPD, the airways have become permanently narrowed or damaged. This is different to asthma, where the airways become narrowed in response to an environmental trigger (e.g. pollen or dust) and is usually reversible.

Care pathways

This pathway is designed to assess and improve the lung function and general health of our patients with COPD.

1️⃣ Book the appointment

1. We are using a combination of platforms / tools / teams to book patients in correctly with minimal manual effort. If @Louis Williams hasn’t already been in touch, check out the page to find our Monthly Summary plans or reach out to him to find out what you should be doing:
• If we’re using Hippo Labs, log into app.hippolabs.co.uk to find patient lists (see for more information)
• If we’re using Hero Health or AccuRX, @Louis Williams will send your team manual excel recall lists

2. Call patient to book the appointment with the Nurse (F2F)

Advise the patient to bring all their inhalers to the appointment

2️⃣ Patient arrives for appointment

1. Record that the patient has arrived in the appointment book
2. Allow the patient a moment to relax before asking to capture data on height, weight, blood pressure, smoking status, and alcohol status (if possible) and add to patient’s EMIS record
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How-to guides

3️⃣ Carry out review

1. Open the clinical template ‘Penrose Health - COPD’ on EMIS and complete annual review
2. Offer influenza and pneumococcal vaccination (if appropriate)
3. Use RightBreathe for prescribing information

Be aware of the environmental effects of inhalers and understand options for patients → see NG80 Asthma inhalers and the environment patient decision aid (nice.org.uk)

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If the patient has asthma and COPD, do not stop steroid inhalers if they have already been prescribed.
4. Offer patient education and appropriate referrals
• For smoking cessation, refer to 🚭Southwark Stop Smoking Service, 🚭Lewisham Stop Smoking Service or 🚭Lambeth Stop Smoking Service
• Encourage patients to download the RightBreathe app (Apple & Google Play) for demonstration of inhaler technique.
• Newly diagnosed patients require evidence of non-reversibility - if spirometry required, refer to 🫁KCH Respiratory, 🫁Lewisham & Greenwich Trust Community Respiratory Team or
5. Check if patient has used COPD Rescue pack recently, and replace if necessary
• remind patient to contact surgery if they have started to use rescue pack
• refer to appropriate borough Respiratory team if rescue pack is used