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Strategies for the prevention, diagnosis and treatment of COPD in low- and middle- income countries: the importance of primary care

Rossaki, FM; Hurst, JR; Van Gemert, F; Kirenga, BJ; Williams, S; Khoo, EM; Tsiligianni, I; ... Van Boven, JF; + view all (2021) Strategies for the prevention, diagnosis and treatment of COPD in low- and middle- income countries: the importance of primary care. Expert Review of Respiratory Medicine , 15 (12) pp. 1563-1577. 10.1080/17476348.2021.1985762. Green open access

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Abstract

INTRODUCTION: Low- and middle-income countries (LMICs) bear a high proportion of the global morbidity and mortality caused by COPD. Increased exposure to risk factors throughout life (e.g. malnutrition, indoor and outdoor air pollution, smoking) is associated with higher COPD prevalence in LMICs and the lack of treatment availability increases avoidable harm. AREAS COVERED: This review covers the epidemiology and burden of COPD in LMICs, and challenges and recommendations related to healthcare systems, prevention, diagnosis and treatment. Main challenges are related to under-resourced healthcare systems (such as limited availability of spirometry, rehabilitation and medicines). Lack of policy and practical local guidelines on COPD diagnosis and management further contribute to the low diagnostic and treatment rates. In the absence of, or limited number of respiratory specialists, primary care practitioners (general practitioners, nurses, pharmacists, physiotherapists and community health workers) play an even more pivotal role in COPD management in LMICs. EXPERT OPINION: Raising awareness on COPD, educating healthcare workers, patients and communities on cost-effective preventive measures as well as improving availability, affordability and proper use of diagnostic and pharmacological and non-pharmacologic treatment in primary care are the key interventions needed to improve COPD prevention, diagnosis and care in LMICs.

Type: Article
Title: Strategies for the prevention, diagnosis and treatment of COPD in low- and middle- income countries: the importance of primary care
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1080/17476348.2021.1985762
Publisher version: https://doi.org/10.1080/17476348.2021.1985762
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: COPD, air pollution, burden of disease, diagnosis, education, low and middle income country, prevention, primary care, smoking, treatment
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Respiratory Medicine
URI: https://discovery.ucl.ac.uk/id/eprint/10135967
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