Chronic Obstructive Pulmonary Disease in Primary Care: All You Need to Know to Manage COPD in Your Practice(Class Health)

This clear and helpful resource manual addresses the management requirements of GPs and practice nurses. In this book, you will find guidance, protocols, plans and tests - all appropriate to the primary care situation - that will streamline your diagnosis and management of COPD

Table of Contents:
Foreword by Dr David Halpin ix Foreword to the first edition by Greta Barnes x Foreword to the first edition by Professor Peter Calverley xi Acknowledgements xiii Abbreviations xiv 1 Introduction 1 Main points 1 What is new in this third edition 2 Why COPD is important 2 How important is COPD? 4 What is the economic burden of COPD? 5 Doctors' and patients' attitudes to COPD 6 What can be done? 8 2 Pathology and pathophysiology 10 Main points 10 Risk factors 12 Chronic asthma 17 Chronic bronchitis 18 Emphysema 19 Small airways disease 22 COPD - a mixed spectrum of diseases 23 3 Presentation and history 28 Main points 28 Symptoms 29 History taking 31 Clinical signs 32 Summary 34 4 Spirometry and lung function tests 35 Main points 35 Spirometry 36 Why is FEV1 the preferred test? 43 COPD in Primary Care Flow/volume measurement 45 Early screening for COPD 48 5 Assessment 51 Main points 51 Making the diagnosis and establishing a baseline 52 Bronchodilator reversibility 53 Corticosteroid reversibility 55 Excluding alternative and coexisting pathologies 56 Disability and handicap 58 Assessing breathlessness 59 Assessing walking distance 61 Assessing the impact of the disease on daily activities 62 Impact of the disease on psychosocial functioning 62 Assessing health status 63 Summary 65 6 Smoking cessation 68 Main points 68 Why do people smoke? 69 How can smokers stop smoking? 70 Nicotine replacement therapy 72 Bupropion 76 Helping patients to stop smoking 77 7 Pharmacotherapy 82 Bronchodilators 82 Main points 82 How do bronchodilators work? 84 Short-acting bronchodilators 85 Long-acting inhaled bronchodilators 86 Oral long-acting bronchodilators 88 Nebulised bronchodilators 89 Corticosteroid therapy 94 Main points 94 The rationale for using corticosteroids 96 The NICE guidelines advice on inhaled steroids in COPD 96 New clinical information on inhaled steroids 97 What are the implications for primary care? 98 Is there a role for long-term oral steroids? 99 Steroids for acute exacerbations 99 Synopsis of important clinical trials of inhaled steroids in COPD 101 vi Contents Combined inhaled long-acting beta-agonists and corticosteroids 108 Main point 108 Salmeterol/fluticasone studies 108 Formoterol/budesonide studies 109 Mucolytics 110 8 Pulmonary rehabilitation 111 Main points 111 Evidence for the effectiveness of rehabilitation in COPD 112 Why rehabilitation programmes are needed 113 The components of a hospital-based pulmonary rehabilitation programme 115 The role of the primary health care team 118 9 Other forms of therapy 126 Main points 126 Oxygen therapy 127 Surgery 135 Vaccinations 137 Nutrition 137 Exercise 139 Social and psychological issues 139 Severe breathlessness and palliative care 141 10 Acute exacerbations and referral to hospital 145 Main points 145 Defining an exacerbation 146 Management of the acute exacerbation 148 Natural history of an exacerbation 148 Treatment in the community 150 Recurrent exacerbations 152 Prevention of acute exacerbations 152 Hospital-at-home schemes for acute exacerbations 155 Respiratory failure 155 Treatment of associated conditions 156 Consideration of specialist referral 156 11 The NICE COPD guidelines - a summary of the new features 159 Main points 159 Definition 160 Making a diagnosis 161 vii COPD in Primary Care COPD - a multi-system disease 164 New recommendations on drug treatment 164 Pulmonary rehabilitation 166 Hospital-at-home schemes 167 Treatment of exacerbations 167 Self-management action plans 167 Palliative care 168 Assessment of patients with COPD 168 Follow-up and monitoring in primary care 169 12 The GOLD guidelines 171 Main points 171 What is GOLD? 172 The GOLD definition of COPD 172 Goals of management 174 Assessing and monitoring disease 174 Reducing risk factors 176 Managing stable COPD 176 Managing exacerbations 179 Future research 180 13 Drug therapy of the future 181 Main points 181 Anti-inflammatory therapies 181 Antiproteases 182 Alpha-1 antitrypsin 183 Antioxidants 183 Pulmonary vasodilators 184 14 Organisation and training needs 185 Main points 185 Finding the patients 187 The practice nurse's role 190 Protocol and audit 193 Glossary 197 Useful addresses 205 Index 210 Priority Order Form 233

About the Author :
Dr David Bellamy MBE, BSc, FRCP, MRCGP, DRCOG is a recently retired GP with a special respiratory interest. He has taken up clinical teaching on COPD and is working for the GOLD Guidelines. He was a GP representative on the NICE COPD Guidelines Committee Rachel Booker RGN DN (Cert) HV is an independent specialist respiratory nurse, formerly COPD Module Leader at Education for Health, Warwick. She is also author of Vital COPD. The Queen's Nursing Institute have awarded her the Queen Elizabeth the Queen Mother's Award for Outstanding Service

Review :
This is a much needed, very practical book, clearly laid out with a main points section at the start of each chapter and references at the end of the chapter.A useful addition to the practice bookshelf. Practical Nursing COPD in Primary Care fills in the gaps in advising on day-to-day management following the launch of the British Thoracic Guidelines for COPD, and shows that COPD is an important condition that can effectively be dealt with in primary care. If you want to know how ... this book is for you! National Respiratory Training Centre This book continues to represent excellent value and a good starting point for any doctor or nurse interested in learning more about the essentials of managing COPD. Extract from a review on COPD Professional.org website This book, which has been endorsed by the Australian Lung Foundation and the Thoracic Society of Australia and New Zealand, is a goldmine of practical information on the management of a condition that is increasing in incidence and prevalence in our community. I thoroughly recommend it to all medical practitioners who manage chronic lung disease, especially those who are engaged in comprehensive care from the consultation room, through the hospital ward, to the community setting. Medicine Today about the Australian edition