improving the experience of all londoners with copd and minimising the impact of the disease london...
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Improving the experience of all Londoners with COPD and minimising the impact of the disease
London Respiratory Team
Helping people quit smoking
A treatment for COPD
Improving the experience of all Londoners with COPD and minimising the impact of the disease
London Respiratory Team
How do we get there?
Our attitudes; why they matter and what influences them
What works long term and is cost effective?
Issues for London
What can we all do now?
Improving the experience of all Londoners with COPD and minimising the impact of the disease
London Respiratory Team
1950’s- 60’s
Our attitudes; why they matter and what influences them
Improving the experience of all Londoners with COPD and minimising the impact of the disease
London Respiratory Team
1970s: WHO takes a position and our behaviour changes
Our attitudes; why they matter and what influences them
Improving the experience of all Londoners with COPD and minimising the impact of the disease
London Respiratory Team
2007
Our attitudes; why they matter and what influences them
Improving the experience of all Londoners with COPD and minimising the impact of the disease
London Respiratory Team
Improving the experience of all Londoners with COPD and minimising the impact of the disease
London Respiratory TeamR
ate
of
dea
th p
er 1
000
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rso
n y
ears
Cause of death
Anthonisen NR, Skeans MA , Wise RA; Manfreda J, Kanner RE and Connett JE for the Lung Health Study Research Group*Ann Intern Med. 2005;142:233-239.
What works long term and is cost effective?
Improving the experience of all Londoners with COPD and minimising the impact of the disease
London Respiratory Team
What works long term and is cost effective?
Fletcher, Peto: Br Med J 1977; 1 :
Improving the experience of all Londoners with COPD and minimising the impact of the disease
London Respiratory Team
1 year abstinence %
QALY£
Usual care 1.4
Minimal counselling 2.6 14,735
Intensive counselling 6 7,149
Intensive counselling + pharmacotherapy
12.3 2,092
Systematic Review of 9 studies Hoogendoorn M, Feenstra TL, Hoogenveen RT, Rutten-van Mo¨lken MPMH.Thorax 2010: 65:711-718
A cost effective intervention in COPD
What works long term and is cost effective?
Tiotropium QALY £7112Eur J Health Econ. 2007 June; 8(2): 123135
Improving the experience of all Londoners with COPD and minimising the impact of the disease
London Respiratory TeamWhat works long term and is cost effective?
Improving the experience of all Londoners with COPD and minimising the impact of the disease
London Respiratory TeamIssues for London
Improving the experience of all Londoners with COPD and minimising the impact of the disease
London Respiratory Team
54.37% of the UK Bangladeshi population live in London ONS 2001
Issues for London
Improving the experience of all Londoners with COPD and minimising the impact of the disease
London Respiratory Team
The 1:2.5–5 dose equivalence between cannabis joints and tobacco cigarettes for adverse effects onlung function is of major public health significance.
Thorax 2007;62:1058-1063
In 2000, of those aged 11 to 15 years in England, 12 per cent were using cannabis.In England and Wales, 25 per cent of those aged 16 to 19 were using cannabis
Boreham R and Shaw A (eds) (2001) Smoking, Drinking and Drug Use Among Young People in England in 2000
Issues for London
Improving the experience of all Londoners with COPD and minimising the impact of the disease
London Respiratory Team
Our NHS trusts and practices
What message are we projecting about smoking?
Do we go beyond the incentives provided?
How are you doing at 4 weeks, 1 year, beyond ?
Are you a champion for smoking in your trust, practice, PCT, consortia.
What is our data on COPD and smoking. How do we know if we are making a difference
What can we all do now?
Improving the experience of all Londoners with COPD and minimising the impact of the disease
London Respiratory Team
A ‘no-smoking practice’
Brief intervention
Moderate intervention
Intense intervention
> 5 mins
<1 min
2-5 mins
IPCRG Smoking cessation guidance for primary care 2007Adapted from Litt J, et al. Asia Pacific Fam Med. 2003; 2: 175-9
What can we all do now?