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Challenges of working with COPD patients revealed

A recent survey conducted by Nursing in Practice has highlighted primary care nurses' views on managing patients suffering from chronic obstructive pulmonary disease (COPD). The survey results also reveal nurses' concerns about the future of services for patients in light of the recent Department of Health National Strategy on COPD.

Smoking-related disease, particularly COPD, is becoming more common, but a large number of patients are not diagnosed with the condition until they reach their 50s. Further, while around 900,000 people have been diagnosed with COPD, it is estimated that the true number living with the disease could be as high as 3.7 million.1

The Nursing in Practice COPD survey ( - of more than 750 primary care nurses - showed that 80% of nurses would describe caring for patients with COPD as "challenging". Many respondents to the survey admitted that aspects of their work can be frustrating, with the provision of information and lifestyle advice that is so important in the treatment of the condition failing to make a difference in outcomes in many cases.

This is despite the government's attempt to tackle the burden of COPD in the UK with the introduction of a National Strategy, which aims to improve services for patients with COPD, including palliative care, and drive down mortality rates. When it was launched in 2006, the Strategy promised to "ensure that everyone diagnosed with COPD receives equitable, responsive, high-quality and effective provision of health and social care services from the right person, at the right time, in the right place."2

According to the survey, a high percentage of nurses felt that the Strategy would make a difference to the care of patients; however, many outlined concerns about increased workload, meeting targets and having to put in extra time to implement new parameters of care. One nurse pointed out that patients themselves were asking how their care would change as a result, and another said simply that the aim would be "finding the missing millions".

Despite this, many respondents felt positive that the Strategy will bring about change for the better. A practice nurse commented, "I believe it will assist in the effectiveness of COPD management, allowing more impact for practice nurses to discuss needs and essential strategy with GPs".

Finally, the survey also reveals that 45% of nurses find their work rewarding, particularly when patients are helped to quit smoking and adopt a healthier lifestyle, as one nurse practitioner explained: "I get a lot of satisfaction from managing patients effectively, working with families and carers and especially, at the end of life, trying to ensure comfort and support."

1. NICE. Chronic obstructive pulmonary disease. NICE clinical guidelines on management of chronic obstructive pulmonary disease in adults in primary and secondary care. London: NICE; 2004.
2. Department of Health. National Strategy for COPD. Available from:

The COPD online survey took place from 11-25 October 2010. A total of 761 primary care nurses completed the survey, comprising 74% practice nurses, 15% nurse practitioners, 9% district nurses and 1% health visitors. The vast majority of respondents (83%) stated COPD was an area of special interest. This survey was developed and sponsored by MSD.

[[MSD resp 21]]

To read the survey report in full click here