Five years ago, the National Review of Asthma Deaths (NRAD) highlighted the disappointing, yet promising, statistic that two-thirds of asthma deaths could be prevented. What led to the NRAD was the UK's long-stagnant death rate from asthma of 1200 people a year. Since its release in 2014, only one of 19 recommendations has seen partial progress. Even more alarmingly, the death rate has not only failed to decline, it has not even remained stagnant, instead rising by 8% from 2017 to 2018, with 1400 people dying from asthma in the UK in 2018. In fact, According to Asthma UK, its recent analysis of new Office of National Statistics figures has revealed an even bleaker picture—that the death rate of asthma has risen by 33% in the last decade. As a result. Asthma UK is calling on the NHS for urgent action in response to the situation which it has described as ‘a lack of basic asthma care’(The Pharmaceutical Journal, 2019).
In this month's issue of the Journal of Paramedic Practice, we feature two articles focusing on chronic obstructive pulmonary disease (COPD). Asthma and COPD are both diseases of chronic inflammation of the airways causing obstruction of the air flow. They share similar symptoms such as wheeze, cough and shortness of breath. They are two very distinct conditions—but do share important links: one of these is that children who suffer from severe, persistent asthma are nearly 32 times more likely to develop COPD in adulthood (American Lung Association, 2013).
Therefore, improving asthma care, particularly for children (but for all people with asthma), by ensuring the establishment of an asthma action plan, that patients know how to correctly use their inhalers and that they are knowledgeable, empowered and feel a sense of control over their condition, may prevent cases of COPD for future adults.
COPD is the second most common respiratory illness in the UK, after asthma, and is a common presentation to the ambulance service. In the early pages of this issue, you will find two articles focusing on the treatment of COPD: one discussing non-invasive ventilation as a prehospital intervention for acute exacerbation (p. 376), and the other considering the use of oxygen titration therapy for the reduction of hypercapnia risk in people with COPD (p 382).
More than 8 million people in the UK have either COPD or asthma, at a combined cost of about £5 billion a year (British Lung Foundation, 2014). Respiratory illness has however been highlighted as being under-prioritised and neglected in the UK compared with other high-profile diseases such as cardiovascular disease and cancer (Lancet, 2014).
What are your thoughts on the current state of care for COPD and asthma? Write to us at jpp@markallengroup.com and share your perspective.