Chronic Obstructive Pulmonary Disease (COPD)
Chronic Obstructive Pulmonary Disease (COPD) is a preventable, long-term, and progressive respiratory condition that significantly impacts an individual’s health and socioeconomic well-being. It is characterized by persistent airflow limitation in the lungs, leading to symptoms such as chronic cough, progressive breathlessness, and copious sputum expectoration.Burden of COPD:
COPD is a significant health concern in Tamil Nadu, as it is in many parts of India. In India, about 1 in 10 deaths is caused due to COPD. The prevalence of COPD in Tamil Nadu varies by region but is generally high, especially among older adults and individuals with a history of smoking or exposure to indoor air pollution. Being a progressive disease, it is important that it is identified and treated early to reduce morbidity, mortality and the economic loss due to the disease. The prevalence is estimated to be 10 per 1000 or 1 per 100 in the community.To address this issue, it has been decided to propose the Step Wise Approach to Airway Diseases and Systematic Appropriate Management (SWASAM), a comprehensive program for Screening, Early Diagnosis and Referral to higher centre for appropriate management for COPD in Tamil Nadu so as to reduce the Premature Mortality of Non-Communicable Diseases in-order to achieve Sustainable Development Goal 3.4.1 Health goal before 2030.
Structured Approach for Screening and Identification of COPD:
At PHC, clinical symptoms are assessed using a questionnaire (involving 5 questions), those with score of 2 or more are referred to District Head Quarters Hospital/ Medical College Hospital for confirmatory diagnosis of COPD. At DH/MCH, confirmatory diagnosis is done by Spirometric measurements in which those who have Forced expiratory volume in 1 second to forced vital capacity expressed as FEV1/FVC, should be < 0.7 will be diagnosed as COPD.Other measures:
The other range of measures would include- Quitting smoking,
- Regular physical activity that is tailored to the patient’s tolerance,
- Pulmonary rehabilitation,
- Regular assessment of inhaler technique,
- Proper nutrition,
- Oxygen therapy and Ventilator support will be as need based.
