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Spirometry is a component of the diagnosis and management of respiratory conditions in primary care and should ideally be performed via referral to a primary care network respiratory diagnostic service or community diagnostics centre (CDC) with expertise in the diagnosis of the most common respiratory conditions and of less common diagnoses. Where limited resources create a challenge for testing everyone with a new suspected diagnosis of asthma, those with an intermediate probability should be prioritised for spirometry and also FENO where available.

This update from PCRU guest editor and PCRS Executive Chair, Katherine Hickman, gives an overview of the latest edition of the update. Katherine says: "I hope this edition inspires confidence in managing COPD, addressing COVID-19 concerns, and ultimately reflecting on the loss of Dr Iain Small who really was one in a million. I hope you are able to take some time off over the Christmas break, recharge, and come back in the New Year invigorated and impassioned to continue our mission of supporting those with respiratory disease."

In this edition, we focus on COPD and revisit the 2017 PCRS consensus on COPD treatment titled 'Keeping it Simple.' The updated algorithm aligns with the latest GOLD and NICE guidance, and maintains a focus on patient-centred treatment grounded in evidence, medication optimisation, and continuous monitoring. The article highlights the ongoing evolution in COPD management while prioritising patient well-being within the ever-changing healthcare landscape.

In this episode we dive into the topic of breathing pattern disorder. Anna Spathis a Consultant working in Palliative Medicine is in conversation with Catherine Moffat - a specialist respiratory physiotherapist. They both work in the Cambridge Breathlessness Intervention Service (CBIS) - a specialist service for people with long term conditions living with chronic breathlessness. This episode covers three key areas relating to breathing pattern disorder:

This episode features Dr Fiona Mosgrove, GP with special interest in respiratory medicine, in conversation with Professor Robin Taylor, consultant physician with NHS Lanarkshire. Robin has in-depth experience of difficult prognostic conversations with patients with progressive lung disease. This insightful episode dives into why care in advanced lung disease is such an important topic and what we can do as clinicians to help our patients with advanced COPD and Interstitial Lung Disease, and their families.

Spirometry is a component of the diagnosis and management of respiratory conditions in primary care and should ideally be performed via referral to a primary care network respiratory diagnostic service or community diagnostics centre (CDC) with expertise in the diagnosis of the most common respiratory conditions and of less common diagnoses. Where limited resources create a challenge for testing everyone with a new suspected diagnosis of asthma, those with an intermediate probability should be prioritised for spirometry and also FENO where available.

Primary care should seek to identify and provide proactive support to older people living with frailty. An extended consultation should be considered that should ideally include the patient’s usual carer to enable a comprehensive review, confirmation of current diagnoses, and review of all medications. Appropriateness of self-administered medication should be considered if dexterity or cognitive issues are present. Patients should have a clear, concise management plan that is available to and understood by all those providing care.

Dr Fiona Mosgrove (GP with special interest in respiratory medicine) is joined by Professor Mona Bafadhel (Director for King's Centre for Lung Health and Chair of Respiratory Medicine at King's College) and Christine Mwasuku (Research Nurse and First Year PhD candidate funded by Asthma+LungUK) to discuss lung health specifically in women. Their conversation includes whether there are phenotypes of certain lung diseases that are more common in women, the discussions that should be had around menopause, contraception, and lung disease.

PCRS believe that it is the responsibility of every healthcare professional to treat tobacco dependency systematically and effectively. PCRS advocate that people wishing to quit using tobacco should be offered the most effective but also the least harmful methods first to support a quit attempt. Delivery of stop smoking treatment is challenging due to reduced stop smoking services and a current lack of licensed pharmacotherapies. Prescribed NRT, combining short and long acting versions, along with behavioural support is currently the primary treatment choice.