Managing exacerbations of chronic obstructive pulmonary disease

The worldwide incidence of chronic obstructive pulmonary disease (COPD) is increasing and, in parallel, so is the social and economic burden. Mortality data underestimate COPD as a cause of death because the disease is more likely to be cited as a contributory rather than as an underlying cause of death, or may not be cited at all. By 2020, COPD is expected to be the third most common cause of death worldwide yet it receives less funding, publicity and fewer resources than is deemed necessary. The major burden of COPD falls on the patient and carer, and it is difficult to quantify. The quality of life of patients is evident and depends on the severity of their disease and their ability to adapt physically, socially and emotionally to the resulting disability. COPD leads to 30000 deaths per year in the UK. It is a considerable load to the NHS, particularly in the winter months when exacerbations occur most commonly; it results in 13% of all acute medical admissions.