Chronic Obstructive Pulmonary Disease (COPD)

Chronic obstructive pulmonary disease (COPD) affects people who have had prolonged exposure to smoke or other inhaled irritants. The most common cause of COPD in Canada and other developed countries is smoking tobacco. Outdoor air pollution, burning biomass indoors for cooking or heating, secondhand smoke, some workplace exposures, or a rare genetic disorder called alpha-1-antitrypsin deficiency can also lead to COPD. Emphysema and chronic bronchitis are common forms of COPD.

COPD is diagnosed by spirometry that shows evidence of bronchial airway narrowing. As the disease progresses, shortness of breath on exertion becomes more severe and patients may experience exacerbations that can lead to hospitalization and even death. Patients with COPD are also predisposed to comorbid conditions such a lung cancer and coronary artery disease. COPD presents a large burden of disease on our health care system. Prevention by avoidance of smoke and smoking is key to minimizing this burden.

Research

Our researchers have collaborated on a wide array of observational and clinical studies designed to further our understanding of and ability to treat COPD. The CanCOLD longitudinal cohort study explored the prevalence of COPD in Canada as well as the progression of COPD over time and its impact on quality of life and exercise capacity. We have participated in many clinical trials exploring the impact of pharmaceutical approaches in COPD management, which have helped improve the quality of life and reduce exacerbations for patients. We also do interventional studies, such as exploring surgical approaches that aim to improve the quality of life for people with COPD.

By integrating research with care, we are always learning how to provide optimal care for COPD and other respiratory conditions. Many patients with COPD are elderly and suffer from comorbidities. Our researchers have delineated the impact of balance, muscle strength, and pain to improve care for COPD patients. We have found that a comprehensive case management program is effective at reducing the length of hospital stay and subsequent readmission for COPD patients after acute care discharge. Our COPD Transition Team continues to provide this service for patients at Vancouver General Hospital.

Care

The Centre for Lung Health’s COPD clinic has specialist physicians and a respiratory educator to support patients with COPD. The spirometry laboratory provides pulmonary function testing, which is the standard for diagnosis and effective patient follow-up. We offer walk-in spirometry to increase access to this service. We also provide replacement therapy for patients who have COPD due to alpha-1 antitrypsin deficiency.

The COPD Transition Team identifies patients in the hospital with a COPD exacerbation and provides support for them when they return home. The team is integral to preventing further exacerbations among these patients who are at high risk for re-admission. The team’s comprehensive case management approach has been shown to be cost-effective and there is a keen interest in promoting such programs across the province.

COPD is a chronic condition that requires ongoing care and maintenance. We offer a pulmonary rehabilitation program led by a respiratory therapist, often with the support of a physiotherapist. Pulmonary rehabilitation offers education, exercise, and psychosocial support. Patients report improvements in their quality of life, exercise capacity, and feelings of disease mastery and experience fewer exacerbations. We introduced online pulmonary rehabilitation to maintain patient support during the COVID-19 pandemic and developed a unique monitoring system that has the capacity to enhance the virtual program. Patients with advanced COPD for whom home oxygen can improve length and quality of life have access to a Home Oxygen Program funded by the BC Ministry of Health.

Our team focuses on providing optimal evidence-based care and preventive services. We have contributed to the Canadian Thoracic Society guidelines for the management of COPD and have adopted them in our clinics. We have also worked with the BC Guidelines and Protocols Advisory Committee (GPAC) help to educate family physicians about best practices for COPD care. We regularly participate in initiatives to promote spirometry within the Vancouver Coastal Health region and across British Columbia. Currently, we are collaborating with Legacy for Airway Health to develop strategies to improve care for COPD.

Research

Our researchers have collaborated on a wide array of observational and clinical studies designed to further our understanding of and ability to treat COPD. The CanCOLD longitudinal cohort study explored the prevalence of COPD in Canada as well as the progression of COPD over time and its impact on quality of life and exercise capacity. We have participated in many clinical trials exploring the impact of pharmaceutical approaches in COPD management, which have helped improve the quality of life and reduce exacerbations for patients. We also do interventional studies, such as exploring surgical approaches that aim to improve the quality of life for people with COPD.

By integrating research with care, we are always learning how to provide optimal care for COPD and other respiratory conditions. Many patients with COPD are elderly and suffer from comorbidities. Our researchers have delineated the impact of balance, muscle strength, and pain to improve care for COPD patients. We have found that a comprehensive case management program is effective at reducing the length of hospital stay and subsequent readmission for COPD patients after acute care discharge. Our COPD Transition Team continues to provide this service for patients at Vancouver General Hospital.

Care

The Centre for Lung Health’s COPD clinic has specialist physicians and a respiratory educator to support patients with COPD. The spirometry laboratory provides pulmonary function testing, which is the standard for diagnosis and effective patient follow-up. We offer walk-in spirometry to increase access to this service. We also provide replacement therapy for patients who have COPD due to alpha-1 antitrypsin deficiency.

The COPD Transition Team identifies patients in the hospital with a COPD exacerbation and provides support for them when they return home. The team is integral to preventing further exacerbations among these patients who are at high risk for re-admission. The team’s comprehensive case management approach has been shown to be cost-effective and there is a keen interest in promoting such programs across the province.

COPD is a chronic condition that requires ongoing care and maintenance. We offer a pulmonary rehabilitation program led by a respiratory therapist, often with the support of a physiotherapist. Pulmonary rehabilitation offers education, exercise, and psychosocial support. Patients report improvements in their quality of life, exercise capacity, and feelings of disease mastery and experience fewer exacerbations. We introduced online pulmonary rehabilitation to maintain patient support during the COVID-19 pandemic and developed a unique monitoring system that has the capacity to enhance the virtual program. Patients with advanced COPD for whom home oxygen can improve length and quality of life have access to a Home Oxygen Program funded by the BC Ministry of Health.

Our team focuses on providing optimal evidence-based care and preventive services. We have contributed to the Canadian Thoracic Society guidelines for the management of COPD and have adopted them in our clinics. We have also worked with the BC Guidelines and Protocols Advisory Committee (GPAC) help to educate family physicians about best practices for COPD care. We regularly participate in initiatives to promote spirometry within the Vancouver Coastal Health region and across British Columbia. Currently, we are collaborating with Legacy for Airway Health to develop strategies to improve care for COPD.

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