Living Well with COPD: Challenges and Options

Chronic obstructive pulmonary disease is preventable and treatable, especially if diagnosed early.

What Is COPD?

Chronic obstructive pulmonary disease, commonly referred to as COPD, is a slowly progressive inflammatory respiratory disease that affects the airways in the lungs and makes it difficult for affected individuals to breathe and get enough oxygen into their body. COPD refers to a group of diseases that include emphysema, chronic bronchitis, and sometimes asthma.

COPD is the third leading cause of death and one of the leading causes of disability in the United States. It affects more than 15 million individuals, typically between the ages of 65 and 74 years.^1,2 Moreover, an additional 12 million individuals have COPD but are unaware they have the disease or have not been diagnosed.³

Although COPD is a progressive disease, the promising news is it is preventable and treatable, especially if diagnosed in its early stages. Many patients with COPD can lead productive and active lives if they adhere to their treatment regimen and take an active role in their care plan. Empowering yourself with knowledge about COPD and the available treatments is your best defense for managing this disease effectively.

Risk Factors

Research has identified long-term smoking as the main contributing cause of COPD. According to the National Institutes of Health, an estimated 80% to 90% of COPD cases are diagnosed in individuals with a long-term history of smoking.^1,2,4 Nonsmokers can also develop COPD from causes such as longterm exposure to substances that irritate and damage the lungs (eg, air pollution), exposure to workrelated dust and chemical fumes, and exposure to large amounts of secondhand smoke.³ Some individuals develop COPD as a result of a rare genetic disorder known as alpha₁-antitrypsin deficiency.

Signs and Symptoms

At first, COPD may cause no symptoms or only mild symptoms, but as the disease progresses, symptoms may become more severe. The most common symptom associated with COPD is shortness of breath. Other common symptoms include^3,5-7:

• Frequent cough or cough that produces a lot of mucus, especially upon waking in the morning

• Shortness of breath, especially during physical activity

• Wheezing

• Chest tightness

• Inability to take a deep breath

• Frequent respiratory infections

• Fatigue and lack of energy

• Blueness of the lips or fingernail beds

Diagnosis

Your physician will diagnose COPD based on your symptoms, your medical history, and the results of any tests he or she orders, such as lung function tests, blood tests, and chest x-rays or CT scans. Your physician may order a spirometry test, which detects how well your lungs are working. He or she will decide which tests to order and, because each case of COPD is different, determine the best treatment options for you based on your symptoms, medical history, and the severity of the disease.

Treatment

If you are diagnosed with COPD, your physician will determine the best way to manage your symptoms and improve your overall quality of life. There is no cure for COPD, but several treatment options are available to relieve the associated symptoms. These include medications, oxygen therapy, pulmonary rehabilitation, lifestyle modifications, and surgery. If you smoke, quitting is a critical step in treating COPD. The goals of treatment are geared toward relieving symptoms, slowing disease progression, and improving overall quality of life.

Two general classes of medications are used to treat COPD. Maintenance medications are taken on a daily basis to control or prevent symptoms, and rescue medications are taken when needed, especially during COPD flare-ups or for immediate relief when symptoms worsen. Medications often used in the treatment and management of COPD include bronchodilators, inhaled steroids, combination inhalers that contain bronchodilators and steroids, oral steroids, and antibiotics.

Your pharmacist will counsel you on the proper way to use your prescribed medications, especially regarding the appropriate method of using inhalers to ensure that you receive the proper dose and understand how to use the inhaler device correctly. It is imperative that you take medications exactly as directed, adhere to your medication regimen, and discuss any concerns with your physician or pharmacist.

In addition to your prescribed medication therapy, the pneumococcal vaccine and yearly influenza vaccine are recommended for all patients with COPD because this patient population is at greater risk for developing these infections. It is important to talk to your physician about these vaccinations.

Complications of COPD

The most common complication of COPD is referred to as an exacerbation or flare-up. Your physician will devise a treatment plan to effectively manage flare-ups. Left untreated, COPD can cause or contribute to other serious health issues, such as cardiovascular disease, respiratory infections (colds, flu, and pneumonia), lung cancer, and depression.

Living with COPD

You can manage your COPD by adhering to your prescribed medication therapy, quitting smoking, and avoiding lung irritants. Your physician and pharmacist can provide you with information about smoking cessation therapies. It is imperative that you take your medication as prescribed and maintain routine follow-ups with your doctor. It is important to keep an active list of your medications, exercise when possible, eat a balanced and nutritious diet, and reduce stress.

To prevent possible drug—drug interactions, always consult your pharmacist or physician before taking any medications, including nonprescription medications and supplements. Also seek immediate medical care when you are not feeling well or if your symptoms show signs of worsening. Always contact your physician if mucus changes color, consistency, or amount; if you experience shortness of breath or wheezing even after your take your medication; or you have difficulty breathing. It is important that you learn the warning signs of a flareup and what to do when a flare-up occurs.

Living with COPD may present challenges, especially as the disease progresses, so it is essential to seek help when needed and to join a support group for patients with COPD to learn methods of coping with the disease. Although there is no cure for COPD, you can lead an active life, especially if the disease is diagnosed in its early stages.

Ms. Terrie is a clinical pharmacist and medical writer based in Haymarket, Virginia.

References

• What is COPD? Centers for Disease Control and Prevention website. www.cdc.gov/copd/. Accessed February 15, 2015.
• Chronic obstructive pulmonary disease fact sheet. American Lung Association website. www.lung.org/lung-disease/copd/resources/facts-figures/COPD-Fact-Sheet.html. Accessed February 15, 2015.
• COPD: The more you know, the better for you and your loved ones. NIH National Heart, Lung, and Blood Institute website. www.nhlbi.nih.gov/health/educational/copd/campaign-materials/html/copd-atrisk.htm. Accessed February 15, 2015.
• Understanding COPD. American Lung Association website. www.lung.org/lung-disease/copd/about-copd/understanding-copd.html. Accessed February 15, 2015.
• Symptoms of COPD. NIH National Heart, Lung and Blood Institute website. www.nhlbi.nih.gov/health/educational/copd/what-is-copd/symptoms.htm. Accessed February 15, 2015.
• COPD. Medline Plus website. www.nlm.nih.gov/medlineplus/copd.html. Accessed February 15, 2015.
• About COPD: Symptoms, diagnosis and treatment. American Lung Association website. www.lung.org/lung-disease/copd/about-copd/symptoms-diagnosis-treatment.html. Accessed February 15, 2015.