Respiratory Conditions
Despite the burden of respiratory disease in Scotland there is no national strategy for respiratory disease.
However, much of the 2012 Department of Health outcomes strategy for COPD and asthma and more recent long term plan for respiratory diseases is of clinical relevance.
We need to do more to detect and diagnose respiratory problems earlier. Currently around a third of people with a first hospital admission for a COPD exacerbation have not been previously diagnosed. It is important to reduce variation in the quality of spirometry testing.
Pulmonary rehabilitation offers a range of options tailored to the patient including structured exercise and education programme designed for those with lung disease or breathlessness. 90% of patients who complete the programme experience improved exercise capacity or increased quality of life. However, it is currently only offered to a small percentage of eligible COPD patients, with a focus on those with more severe COPD. We need to ensure more COPD patients benefit from structured evidence informed pulmonary rehabilitation.
The Gold report (Global initiative for Chronic Obstructive Lung Disease) outlines a strategy for diagnosis, management and prevention of COPD.
Key elements include: Ensure correct diagnosis and spirometry Smoking cessation Inhaler technique assessment Flu and pneumococcal vaccination Pulmonary rehabilitation – structured 6 to 8 week programme Long term oxygen therapy |
Four key areas are identified for focus in Quality Prescribing for Respiratory 2018-21
- High dose steroids in adults with COPD and asthma
- High dose steroids in paediatric patients with asthma
- Patients over-prescribed reliever treatments
- Prescribing of inhalers by brand