Chronic Obstructive Pulmonary Disease (COPD) is a serious medical condition and is the 10th leading cause of death in Singapore.1The most important cause of COPD is cigarette smoking. Thus, not smoking cigarettes is the best way to prevent COPD and quitting smoking is the best way to stop the progression of this disease.
NUH's COPD programme is targeted towards preventing acute attacks of COPD, prolonging the survival and improving the symptoms and quality of life for our patients. We achieve this by taking on several approaches, including medications, smoking cessation therapy, education/counselling by experienced COPD Case Managers (nurse clinicians) and pulmonary rehabilitation.
In collaboration with our colleagues in the Emergency Medicine Department (EMD), we have also designed a comprehensive management programme for acute attacks of COPD. Severely ill patients who do not respond promptly to medical treatment will receive noninvasive ventilation (NIV) in the EMD itself to avoid the complications of tracheal intubation and prolonged ICU stays. Less ill patients will be assessed and treated in our EMD's Extended Diagnostic Treatment Unit (EDTU). If they are better, they may go home directly from the EMD.
As a chronic illness like COPD is often best managed at home, our case managers would follow-up with our patients discharged from EDTU or from the inpatient wards to assist them in coping with acute attacks. This is ensure that our patients recover smoothly from an acute attack. Our specialists would review our patients in the outpatient clinics and tailor management according to their needs. For patients who are persistently symptomatic from advanced COPD we have embarked on an advanced care programme to optimise their quality of life and symptom control either at home or in a hospice setting with palliative care physicians.
COPD is a major cause of hospitalisation and death internationally. Our team in NUH has been constantly improving the clinical outcomes of our patients with COPD. In 2020, the inpatient mortality rate is less than 5%, with ALOS 3.8 days and a re-admission rate of less than 20%.2
This material does not cover all information and is not intended as a substitute for professional care. Please consult your physician on any matters regarding your health.
1. https://www.moh.gov.sg/resources-statistics/singapore-health-facts/principal-causes-of-death Last accessed 15 Dec 2020.
2. NUHS Academic Informatic Office: COPD Value Driven Outcomes (VDO) database. Last accessed 15 Dec 2020.
