Reducing COPD flare-ups in winter

Chronic obstructive pulmonary disease (COPD) is the name for a group of lung conditions that cause breathing difficulties. It includes: 

• emphysema – damage to the air sacs in the lungs; 
• chronic bronchitis – long-term inflammation of the airways. 

The main symptoms of COPD are: 

• shortness of breath, particularly when you're active; 
• a persistent chesty cough with phlegm – some people may dismiss this as just a "smoker's cough"; 
• frequent chest infections; 
• persistent wheezing. 

COPD is currently one of the leading causes of death worldwide and is highly prevalent in the general population. In the UK, COPD contributes to NHS winter pressures, for every drop in temperature below 5'C there is a 10.5% increase in GP respiratory consultations and a 0.8% increase in respiratory admissions. 

That’s why this year’s World COPD Day theme aims to highlight the importance of measuring lung function, also known as spirometry, so more people are tested and diagnosed for COPD, leading to better care and reducing the risk of flare-ups (when symptoms suddenly get worse) and hospital admissions.

Actions to prevent COPD flare-ups and improve quality of life are taking place worldwide. For one, Respiratory Consultants Dr Amy Dewar (Guy’s and St Thomas’ NHS Foundation Trust) and Dr Laura-Jane Smith (King’s College Hospital NHS Foundation Trust) have launched a joint COPD programme, OPTIMISE COPD, in south east London to help reduce the risk of COPD flare-ups and hospital admission.  

We caught up with Dr Amy and Dr Laura-Jane to learn more about the programme.
OPTIMISE COPD is a practical approach to identify and support patients with COPD who are at risk of flare-ups in winter and beyond. The proactive programme optimises care now instead of waiting for patients to get sick, giving them more control over their health. 

OPTIMISE supports consistent and comprehensive reviews of patients, whether this be virtual or face-to-face. Some of the process includes ensuring patients are on the best combination of medications; assessing patients for pulmonary rehabilitation (PR); supporting patients to use inhalers correctly; advising on the link between physical and mental health; and providing access to a self-management app with specialist advice to keep patients well over winter. 

The programme highlights the benefits of collaborative partnership working by bringing together cross-site Integrated Respiratory Teams, with support from the Health Innovation Network and the South East London (SEL) Integrated Care Board, to deliver the best care possible for patients. Patients may be seen by one of our consultants, specialist nurses, physiotherapists, or pharmacists, illustrating excellent cross-site multi-disciplinary team working. Where appropriate, we can also directly refer patients to local councils and third sector organisations for wider, well-rounded support. 

Dr Laura-Jane Smith, said: 

"The OPTIMISE programme gives patients the opportunity to have a full lung health MOT from a specialist team. If patients have not had quality assured spirometry with their GP, we will do this as part of their review, supporting this year’s World COPD Day theme of undertaking spirometry to accurately diagnose patients and support good health.

"Chronic respiratory disease is a CORE20PLUS5 priority area for accelerated improvement, so it has never been more vital to support existing COPD patients, find those at-risk of COPD and reduce unwarranted variation in care."

Dr Amy Dewar, said:

"We are one of just four teams nationally who won funding from NHS England to locally launch the OPTIMSE programme for COPD patients. By identifying those at-risk and putting in place processes of care that stop or reduce flare-ups, we have the opportunity to decrease hospital admissions and provide better care for patients, particularly those who are more deprived."

If you work at a south east London GP practice, you can support us to reduce the risk of flare ups this winter by stratifying patients to target those most at-risk. To find more information about how you can support patients this winter, or to receive a copy of the programme leaflet, please contact laura-jane.smith@nhs.net or Amy.Dewar@gstt.nhs.uk.

If you are a south east London patient and are concerned about your symptoms or COPD flare-up this winter, contact your local GP about having an expert COPD review. 

King’s Health Partners Cardiovascular and Respiratory Partnership’s vision is to be a world-leading collaboration by building on the expertise of all our partners in heart, lung and critical care, to deliver the best outcomes for patients through pioneering care, research and education. The Partnership also supports the KHP Respiratory and Allergy CAG to deliver on KHP’s priorities in population health, personalised medicine, digital and data sciences, underpinned by a mind and body approach. 

Find out more about King’s Health Partners Cardiovascular and Respiratory Partnership.