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You’re likely seeing the devastating health impacts of Chronic Obstructive Pulmonary Disease (COPD) among your residents on a daily basis. The U.S. Centers for Disease Control (CDC) reports that COPD is now the third leading cause of death in the United States. Economically the cost of COPD is staggering. Indirect and direct health expenditures totaled more than $50 billion in 2010.
For long-term care professionals, COPD nursing management is complex, and the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines can be challenging to navigate. Let’s take a closer look at COPD, symptoms, disease diagnosis, the Gold Guidelines and how HealthDirect can support your COPD nursing management.
What is COPD?
COPD is a group of diseases that includes emphysema, chronic bronchitis and sometimes asthma. These often treatable and potentially preventable diseases are characterized by breathing problems and a blockage of airflow. In the United States, a common factor to the development of COPD is smoking, although other air pollutants, genetics, abnormal lung development and respiratory infections can also contribute.
Long-term care facilities are essential in the battle against COPD because it is most common among older adults age 65 and up. Others at risk for COPD include current or former smokers, people with a history of asthma, American Indian/Alaska Natives and multiracial non-Hispanics.
In many cases, COPD is both preventable and treatable. Prevention is possible by avoiding exposure to tobacco smoke, air pollutants at home and at work and respiratory infections.
Symptoms and diagnosis of COPD among long term care patients
Symptoms of COPD may include an ongoing cough or a cough that produces a lot of mucus, shortness of breath (especially when physically active), wheezing or a whistling sound when breathing and tightness in the chest. Advanced COPD can cause additional symptoms, such as swollen ankles, feet or legs; weight loss and low muscle endurance. Be on the watch for symptoms that may require emergency care:
- Difficulty catching their breath or talking
- Rapid heartbeat
- Blue lips or fingernails
- Compromised mental ability
Early detection of COPD is essential to managing progression of the disease. Through spirometry, a simple test to measure lung function, a medical professional can test for COPD in any individual. Spirometry can even detect COPD before a patient develops symptoms. A medical professional may recommend other tests for patient diagnosis, including a chest x-ray, a chest CT scan and an arterial blood gas test. These can help determine whether another condition is causing the patient’s symptoms.
Understanding the COPD GOLD Guidelines
The GOLD guidelines provide LTC and other care professionals with valuable COPD nursing management information, including a review of current evidence for the assessment, and diagnosis and treatment for individuals with COPD. The severity of the disease is classified according to these guidelines, based on a post-bronchodilator FEV1.
From there, symptoms are further measured to determine which group the patient falls within:
- The Modified British Medical Research Council (mMRC) measures breathlessness.
- The COP Assessment Test (CAT) provides comprehensive symptom assessment.
- Exacerbation history is gathered for the previous year including prior hospitalizations.
HealthDirect: Your partner in COPD nursing management
HealthDirect is proud to be your partner in COPD nursing management. We can provide consultative advice on emerging treatment for COPD, and appropriate medications for drug therapy for patients at all levels of disease progression. In addition, we offer expert consultation on the complex regulations surrounding COPD through our Delivery at Discharge program, to ensure prehospitalization of patients is minimized.
Connect with your HealthDirect pharmacy consultant for more information on regulatory considerations, COPD GOLD guideline implementation and COPD treatment options. Also, stay tuned for part two in the COPD series—treatment plans, effective treatment options, best fit delivery devices and training. Have questions about COPD GOLD guidelines? Contact your HealthDirect consultant pharmacist using the form below.