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Chronic obstructive pulmonary disease (COPD) is a major cause of mortality and morbidity, which affected 44 million people in the world in 1990 and killed 2.88 million people in 2000. The major risk factor for the development and progression of disease is cigarette smoking, although other behavioural, environmental and genetic factors can contribute to its aetiology.
COPD is routinely under-diagnosed in general practice, where the actual prevalence is estimated to be twice that of identified sufferers and accurate diagnosis therefore remains pivotal to an adequate management of the condition. A range of pharmacotherapies - used singly or in combination - currently exist for the medical management of COPD, although each class of drug has its limitations and the prolonged use of some is limited by concerns over long-term toxicity. New classes of drugs are urgently required and are currently being researched. Surgical management is considered appropriate in advanced disease but its impact is more on quality of life than on survival itself. Currently, much effort has been invested in the development of evidence-based programmes for pulmonary rehabilitation aimed at managing disability and reducing handicap. |
