Concerns for Chronic Obstructive Pulmonary Disease, the top ten leading causes of death

“There was a night when I were coughing so hard and had shortness of breath. I was then diagnosed with Chronic Obstructive Pulmonary Disease (COPD) after seeking consultation in the Accident and Emergency Department,” said Mr Koo, a seventy-year-old man. Mr Koo, who had a long history of smoking for more than 35 years, quitted smoking in 2000. However, he was diagnosed with COPD a month after smoking cessation. He had had shortness of breath when he was walking, yet he didn’t pay attention to it because he thought he just act up due to oldness. Most of the COPD patients and the general public have the same misunderstanding as Mr Koo, not knowing that COPD will severely affect one’s daily living, and even bring possible fatal risk.

The public misconceive and misunderstand COPD

Among the top ten leading causes of death in Hong Kong, diseases such as cancer, heart attack and kidney disease are well-known by the public; yet, COPD, being the ninth leading cause of death [1], lacks public awareness. Recently, The Hong Kong Society for Rehabilitation Community Rehabilitation Network collaborated with Hong Kong Lung Foundation, Hong Kong Thoracic Society and CHEST (Delegation Hong Kong and Macau) to conduct a questionnaire survey and collected data to assess the general public and patients’ understandings on COPD. The result shows that both the public and patients have inadequate understandings.

According to the survey, nearly 40% of the respondents are or were smokers and 30% of them expose to second-hand smoke frequently. However, more than 70% of the general public have never heard of COPD; and more than half of interviewed smokers have never heard of it either. Besides, only one-fifth of the respondents can identify smoking as the major cause of COPD, while one-fourth of them wrongly identified old age as one of the causes. Around one-third of the respondents misconceive that COPD is infectious which shows the public has quite a lot of misunderstanding. Moreover, more than 80% of the respondents did not notice that COPD may cause death, and around 75% of the high-risk smokers believe COPD does not cause death either. Only one-fifth of the interviewers realized COPD is one of the top ten leading causes of death.

Respondents’ misunderstanding on COPD (Number of respondents: 485)

Questions	Correct answers	% of correct respondents
Is COPD one of the top ten leading causes of death?	Yes	18%
What is one of the major causes of COPD?	Smoking	23.13%
Is COPD infectious?	No	68%
Does COPD cause death?	Yes	6%

COPD is highly related to smoking, yet it is not fully understood by the high-risk smokers and the general public. People having lots of misconception and little understanding of COPD is an issue of concern and requires attention.

Long-term exposure to second-hand smoke is also a major cause of COPD

Ms Tang, a 74-year-old lady, never smokes. Yet, her husband and the two sons have the hobby of smoking. In 2002, she realized that she had prolonged coughing and had not subsided for a long time, so she sought consultation from a doctor and was diagnosed with COPD.  The doctor believed her medical condition is related to the long-term exposure to second-hand smoke. Ms Tang has been taking medication but her lung function did not function well. In recent years, she even finds difficulty in bathing and has to use oxygen at home, not to mention doing outdoor sports. The disease has seriously affected her daily life and self-care ability.

Good self-management can manage patients’ condition effectively

It is suggested that medical consultation should be sought as soon as possible if you have the following symptoms: prolonged coughing, lots of sputum, shortness of breath, difficulty in breathing, decreased physical strength and activity.  You should also attach great attention to COPD and quit smoking if you are a frequent smoker, always expose to fumes and dust in the working environment, or face indoor pollution.

Apart from drug treatment, self-management can facilitate the person to do all that a person for managing the health condition to live as fully as possible.  Self management comprises of medical management; role management and emotional management. Through participating in rehabilitation courses, patients can understand their condition, as well as medical treatment, skill and techniques to apply energy conservation to daily living.  Patients need to adjust changes due to physical limitation and role alteration. Continuing the usual work and hobbies, as well as looking for new hobbies and social networks are useful in adapting to these changes.  It is also important to relieve the emotional stress and maintain positive thinking. The Hong Kong Society for Rehabilitation Community Rehabilitation Network offers a variety of support services which help the patients and families to face the disease positively and learn to live with the disease through patient support network.

Enquiries: 25497744 (Kornhill Centre) or 26360666 (Prince of Wales Centre)

[1] Hospital Authority Statistical Report (2016-2017). Available at http://www.ha.org.hk/haho/ho/stat/HASR16_17_4.pdf.