This article will explore common comorbidities in chronic obstructive pulmonary disease (COPD), their manifestation and impact on patient management, and how this affects the patient experience of disease. It will also discuss how the presence of more than one disease in individuals in an ageing population requires a shift from providing disease-focused to patient-centred care.
Comorbidity is likely when one disease complicates the outcomes of the other, and the interaction between them increases the expected mortality risk within the general population.1
The conditions most frequently associated with COPD include cardiovascular disease, lung cancer – which is often the cause of death for COPD patients, osteoporosis, depression and anxiety – which are both associated with poor health status and prognosis.1
COPD management must incorporate looking for and treating comorbidities. This is especially important where conditions have similar symptoms for example, breathlessness is common in lung cancer and heart failure; fatigue and reduced physical activity is common in depression, gastro-oesophageal reflux (GORD) can aggravate symptoms of persistent productive cough and lengthen exacerbations. More than 70% of those with COPD have multimorbidity, with more than two other long-term conditions (LTCs), and over 1 in 10 have more than 6 comorbidities 2 (see Box 1)