Prevention and management of COPD in China: successes and major challenges

Chronic obstructive pulmonary disease (COPD) is the second leading cause of morbidity and mortality in China, where the overall prevalence was 8·2% in 2004. 1 Zhong N Wang C Yao W et al. Prevalence of chronic obstructive pulmonary disease. A large, population-based survey. Am J Respir Crit Care Med. 2007; 176: 753-760 Crossref PubMed Scopus (610) Google Scholar COPD represents an immense economic burden and considerably impairs lung function, exercise tolerance, and quality of life of patients. The substantial impact on patients, the health-care system, and society has motivated researchers to unravel the risk factors of COPD and explore new ways for prevention and management. In the past decade, China has witnessed research progress that should lead to improved patient management in clinical practice. Successes and challenges of COPD management in Australia: reflections on the past and futureNo mention of successes in the management of COPD in Australia should be made without acknowledging the huge gains brought about by multifaceted public health initiatives to reduce tobacco use in the past two decades. These initiatives include tobacco-free workplace policies, increased excise and taxes, restricted advertising and sponsorship, legislation on smoke-free public spaces, explicit messaging and images on cigarette packaging, community advocacy, and education. Total consumption of tobacco and cigarettes in Australia is the lowest ever recorded, fewer young people are smoking, the average age of smoking initiation is increasing, and daily smoking rates have continued to decline by a mean of 7·6% every 3 years since 1991. Full-Text PDF COPD service delivery in the UKThe care and management of chronic obstructive pulmonary disease (COPD) represent a socioeconomic challenge worldwide. Strategies in the UK have centred around ensuring equality of care for all, management nearer to home, patient education and self-management, and supported hospital discharge, with the long-term aim being the seamless management of patients from diagnosis to end-of-life care. To achieve this goal, closer links between primary and secondary care have been established, training and education have been provided to allied health-care professionals (ie, disciplines other than physicians and nurses—eg, respiratory physiotherapists, and pharmacists), and clinical practice has been audited. Full-Text PDF Meeting the challenge of COPD care delivery in the USA: a multiprovider perspectiveThe burden of chronic obstructive pulmonary disease (COPD) in the USA continues to grow. Although progress has been made in the the development of diagnostics, therapeutics, and care guidelines, whether patients' quality of life is improved will ultimately depend on the actual implementation of care and an individual patient's access to that care. In this Commission, we summarise expert opinion from key stakeholders—patients, caregivers, and medical professionals, as well as representatives from health systems, insurance companies, and industry—to understand barriers to care delivery and propose potential solutions. Full-Text PDF