Chronic Obstructive Pulmonary Disease
Chronic Obstructive Pulmonary Disease (COPD) becomes more severe as time goes by and results in increasing breathlessness and disability. In a community like ours, with very few coal mines, it is almost always down to smoking. Detecting it early enables us to help sufferers to stop smoking and to try to slow down the rate at which their lungs deteriorate.
Click on a graph to see it full size.
Smoking
The most obvious thing about this graph is that the numbers of people with COPD seem to be rising. This is because of our efforts to identify people whose disease is at an early stage. It is much better to try to prevent deterioration than to manage the damage once it has developed.
The second most obvious thing is that the number and percentage of non-smokers is steadily growing. Practically all of the patients represented on the graph will have been heavy smokers in the past so this represents a mighty effort. The red band is still too big for our liking though.
Treatment
When we first decided our practice policy in 2002 we agreed that treatment with bronchodilator drugs (to open up the airways) was the first step and that, whatever other treatment was necessary, practically everyone would require such an inhaler. We set a target of 95%.
This policy was restated following the publication of the NICE guidelines on COPD (2004) but our performance did not seem to be improving. The computer search which generates the graphs was found to be at fault. In 2004 and 2005 we were changing people to new combination inhalers that were not being picked up by the search. The search was rewritten for 2006 hence the apparent dramatic improvement. A warning of the dangers of believing graphs!
