The first-ever New Zealand COPD (Chronic Obstructive Pulmonary Disease) Guidelines have been published in the New Zealand Medical Journal today, providing a national framework for diagnosis and management of COPD in a New Zealand context.
Affecting more than 15% of New Zealand adults over the age of 45, and encompassing emphysema, chronic bronchitis, and chronic airflow obstruction, COPD is irreversible and usually progressive. People with COPD are more at risk to severe illness from contracting COVID-19, as listed on the Ministry of Health's website of severe underlying medical conditions.
The guidelines have been developed by the Asthma and Respiratory Foundation’s (ARFNZ) working group of respiratory health experts led by Dr Stuart Jones from Middlemore Hospital and Professor Bob Hancox from the University of Otago, with the goal of improving diagnosis, and laying out clear recommendations for assessment and management of this respiratory disease.
Dr Jones, also ARFNZ’s Medical Director, says "For too long the diagnosis and management of COPD in Aotearoa New Zealand has been a postcode lottery. The publication of these guidelines with their evidence-based standards of care will hopefully provide a level playing field for all New Zealanders, and as a result, improve the well-being of our people."
The burden of COPD among Māori is one of the most significant health disparities in New Zealand with hospitalisation rates 3.5 times higher than non-Māori and mortality 2.2 times higher. Similarly, Pacific people are disproportionately affected with hospitalisation rates 2.7 times higher than those of other New Zealanders. Greater exposure to environmental triggers such as smoking and poor housing, as well as access to understandable health information are key factors.
Cultural considerations and the importance of non-pharmacological management of COPD are key aspects of the guidelines that make them relevant to New Zealand healthcare practice.
Joanna Turner, Research and Education Manager, ARFNZ says "Medication does help to control and relieve the symptoms of COPD, but non-pharmacological management is equally as important to ensure good quality of life.
"Stopping smoking is key to preventing further loss of lung function and other wrap-around management such as exercise, nutrition, pulmonary rehabilitation, and teaching techniques to control breathlessness will aid in slowing progression of the disease. COPD is all about support - there’s plenty out there, it’s about knowing where to go."
Many of the same breathing techniques and breathlessness strategies outlined in the new COPD guidelines are currently being trialled overseas for patients with symptoms of long Covid.
Effective management of the disease is particularly important in COPD, as every flare-up of symptoms will worsen lung function.
Professor Bob Hancox adds "A flare-up should be an indicator for clinicians to review both pharmacological and non-pharmacological treatments and develop a personalised action plan for patients. Checking inhaler technique is also critical - too many people don’t get the best out of their inhalers because they have not been taught how to use them properly."
Letitia Harding, Chief Executive, ARFNZ knows that the guidelines are highly anticipated as shown by the keen interest from healthcare professionals at the Foundation’s recent New Zealand Respiratory Conference where they were first introduced.
"The burden of COPD translates to lost years of healthy lives for many New Zealanders. The Foundation is proud to lead the development of these guidelines alongside an exemplary team of experts, with the goal of improving COPD care in New Zealand" says Letitia.
For more information, or to access copies of the guidelines, visit www.nzrespiratoryguidelines.co.nz/copdguidelines
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