Chronic obstructive pulmonary disease (COPD) is defined by a post-bronchodilator FEV1/FVC ratio of less than 0.7.1 It is a progressive condition marked by persistent and largely irreversible airflow obstruction that leads to worsening shortness of breath, reduced exercise capacity, a persistent cough, and increased sputum production. The systemic inflammation present in COPD results in weight loss, skeletal muscle dysfunction, cardiovascular disease, and osteoporosis.2
COPD is thought to affect about 1.2 million people in the UK, and 4.5% of the population of over 40-year-olds are diagnosed with COPD.3 In England, a death occurs every 20 minutes due to COPD.4 However, National Institute for Health and Care Excellence5 estimates that two thirds of people who have COPD in the UK are, as yet, undiagnosed and suggest the total number of cases present in the population is around 3 million. The UK ranks 12th for COPD mortality across the world, and 3rd in Europe behind Denmark and Hungary, respectively.3 In the NHS, 1.4 million GP consultations per year are COPD-related and COPD accounts for 1 in 8 emergency hospital admissions.5 In the UK, the direct cost to the NHS of treating COPD is said to be £1.9 billion.3
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