COPD Selfcare Proposal

We are knocking about with some ideas for a COPD self-care project. I would appreciate some feedback before getting the idea worked up in more detail. This is the more patient friendly version. The more formal proposal is here ;

https://simplestuffblog.wordpress.com/2012/01/31/copd-proposed-pilot-to-facilitate-selfcare-in-east-lancashire/

Please comment by clicking on the speech bubble.

I am a GP ( family physician ) in Lancashire . I set up a weight loss challenge last year that was a pilot for combining health promotion with an element of competition to make it more fun, and try out some gamification concepts. I have been wondering what we could try next. COPD is another health issue that we are not short of in Lancashire.

COPD is a breathing disease that is much more likely to affect you if you smoke. It starts off as a mild irritating cough but can progress to life limiting dependence on piped oxygen. The only thing that stops the progress of the COPD is stopping smoking. Exercising more can help people with COPD regain some of their quality of life. The “pulmonary rehab” tends to be offered to the patients with more severe disease, once they have had a couple of hospital admissions for chest infections. The patients with more mild COPD may not realise that they have it – attributing their cough to their smoking habit. A special breathing test called spirometry is used to help diagnosis. It is available in many GP practices.

Pretty much everyone with COPD stops smoking before they die. You can’t smoke safely with an oxygen pipe attached to your face.

If the patients with mild COPD , i.e. those at the start of their COPD journey could find out that they had it ,and could support one another to change their lifestyle, then they may stop themselves progressing downstream to the moderate or severe COPD.

I am proposing that COPD selfcare could be promoted by the development of an ‘expert patient’ programme that targets the newly diagnosed COPD patients. These could be identified at time of diagnosis by the GP practice. The patient could receive a ‘welcome pack’, which could contain standardised information and an invitation to join a local COPD patient group. The group could be facilitated by health educators but the expectation would be that members of the group would become “activated” – and ‘turned on’ to the self-care model. Individual groups of patients could link up to help pursue goals that they set themselves relating to exercise tolerance, or stopping smoking. Social media could be harnessed to support this, as well as the emerging ‘PIE’ (patient information exchange)” web resource.

Alongside the programme, an education” prescription” could be developed, tested and evaluated to assess its effectiveness so that it could be rolled out in other locations. Using the experience from the Pendle Weight Loss Challenge, we may secure incentives in the form of motivational prizes from local businesses or the leisure trust.

In addition to this, a process of outreach to large employers, educational establishments, retail environments (such as supermarkets and town centres), and voluntary, community and faith sector (VSFS) networks could be mobilised.

The unique selling point of this proposal is that it focuses on patients at the start of their ‘COPD journey’ and empowers them early and where the impact in terms of better management, reduced exacerbations ( number of chest infections), and reduced admissions can be realised, whereas the current emphasis is on rehab of the patient who have already had several admissions.

I would like to know what people think of this proposal. The idea needs to be worked up and costed out in more detail. Please email me your views.

– Regarding how to make it easier for people to link up with other people in their area –

Please contact me via the contact section on the blog if you live in East Lancs and would like to try this idea. Could you include the first part of your postcode and the name of your local pub as this could be a useful place for meeting up.

This video I’ve got COPD but COPD hasn’t Got ME is great for explaining what selfcare means to patients and their lifestyle. It is good to see what difference exercise can make. If we can help to identify people with COPD at an early stage we can make a real difference.