COPD Case Study: Diagnosis, Management, and Treatment

Introduction

This report addresses Chronic Obstructive Pulmonary Disease (COPD) from two perspectives. The first covers the facts and details pertaining to COPD — what is involved in living with and treating the disorder. The second explains how to implement these facts and details in a clinical setting. A case study subject has also been selected and examined as part of this report, including an explanation of the diagnosis, a comparison between established guidelines and the patient's condition, and the treatment and management options available to the patient. While COPD is a grave diagnosis, it can be managed, and quality of life can be maximized following diagnosis.

Understanding COPD: Causes, Symptoms, and Prevention

COPD is usually — though not always — caused by extensive and/or long-term smoking of tobacco and/or marijuana. Quite often, COPD represents the confluence of both chronic bronchitis and emphysema. While smoking is not the only risk factor, many medical scholars have asserted that up to half of all smokers over the age of sixty will develop COPD at some point in their later lives.

Symptoms of COPD include a persistent cough that does not resolve with treatment, the coughing up of mucus, and shortness of breath. Chest tightness is also commonly reported. Emergency intervention is required if breathing stops, if there is moderate to severe difficulty breathing, or if severe chest pain is present. A visit to a regular physician or specialist is warranted if a patient coughs up 0.5 cups or more of blood, experiences progressively worsening shortness of breath or wheezing, notices a cough that is becoming deeper or more frequent, has a high fever (101°F or above), or presents with any combination of flu-like symptoms.

Prevention strategies focus primarily on avoiding smoking — including cigars and pipes — and avoiding areas with poor air quality. Getting vaccinated for influenza, pneumonia, and pertussis (whooping cough) is also strongly advisable, for reasons that extend well beyond COPD. Treatment of COPD is primarily a matter of managing the disease and slowing its progression, as a cure is not currently possible. The general goals of COPD treatment are to slow disease progression, limit symptoms, improve overall quality of life, and prevent or treat flare-ups (WebMD, 2016).

Translating COPD Guidelines to Clinical Practice

There are several ways to translate COPD knowledge effectively into a clinical setting. If a patient is identified as a smoker, that patient must be strongly urged to quit, given the risk of COPD as well as other health consequences such as cancer. The statistic that approximately fifty percent of smokers over the age of sixty will develop COPD should serve as a major warning, though even younger patients can be firmly counseled that smoking will shorten their lives by years or even decades. Regardless of the time lost, quality of life tends to decline significantly, and risks such as secondhand smoke exposure also affect those around the patient.

With respect to treatment planning, patients identified as having COPD should be seen by their physician frequently. A treatment and management plan should be developed based on how far the disease has progressed. Prolonging life, improving quality of life, and minimizing symptoms should be the primary priorities. In addition to clinical treatment options, patients should receive guidance on lifestyle improvements to slow the progression of COPD as effectively as possible (WebMD, 2016).

Conclusion

It is noted in the case study that the patient cannot afford to retire. However, he can apparently afford cigarettes, and smoking is unquestionably the primary factor hurting his quality of life and expected lifespan. If he were to quit smoking and better manage his lifestyle in ways that prevent or at least mitigate his exacerbations, it would yield a substantial improvement in both his prognosis and his daily life. It is imperative that his medical providers make clear to him that his life literally depends on making the correct lifestyle and medical choices.

The medical team cannot compel compliance, but they can play a meaningful role in motivating the patient to change his habits. They must be firm and specific in their communication. The patient is already paying a price for his current choices, and without intervention, that price will only increase.

References

Krieger, A. (2016). Managing COPD: What's your FEV1? EverydayHealth.com. Retrieved January 2, 2016, from http://www.everydayhealth.com/copd/managing-copd-whats-your-fev1.aspx

Tsiligianni, I., Goodridge, D., Marciniuk, D., Hull, S., & Bourbeau, J. (2015). Four patients with a history of acute exacerbations of COPD: Implementing the CHEST/Canadian Thoracic Society guidelines for preventing exacerbations. npj Primary Care Respiratory Medicine, 25, 15023. http://dx.doi.org/10.1038/npjpcrm.2015.23

WebMD. (2016). COPD (Chronic Obstructive Pulmonary Disease) — Treatment overview. WebMD. Retrieved January 2, 2016, from http://www.webmd.com/lung/copd/tc/chronic-obstructive-pulmonary-disease-copd-treatment-overview