Territory Stories

The Northern Territory Disease Control Bulletin

Details:

Title

The Northern Territory Disease Control Bulletin

Creator

Territory Health Services, Centre for Disease Control

Collection

Northern Territory disease control bulletin; E-Journals; PublicationNT; Northern Territory disease control bulletin

Date

2002-03

Location

Casuarina

Notes

Date:2002-03; This publication contains may contain links to external sites. These external sites may no longer be active.; Made available via the Publications (Legal Deposit) Act 2004 (NT).

Language

English

Subject

Communicable diseases; Reporting; Northern Territory; Statistics; Periodicals

Publisher name

Northern Territory Government

Place of publication

Casuarina

Series

Northern Territory disease control bulletin

Volume

v. 9 no. 1

File type

application/pdf

ISSN

1440-883X

Use

Attribution International 4.0 (CC BY 4.0)

Copyright owner

Northern Territory Government

License

https://creativecommons.org/licenses/by/4.0

Parent handle

https://hdl.handle.net/10070/233806

Citation address

https://hdl.handle.net/10070/655675

Page content

The Northern Territory Disease Control Bulletin Vol 9, No.1, March 2002 17 strategy for prevention and management of COPD, including a detailed evidence base.3 In Australia, the Australian Lung Foundation (ALF) is currently developing a COPD handbook, and Australasian evidence-based guidelines.4 Key messages from the guidelines In its early stages COPD is often asymptomatic, though use of a spirometer can identify the presence and severity of airways limitation, and should be performed in people who have been smoking for more than a few years. By the time people feel short of breath, lung damage is usually fairly advanced. Stopping smoking is the only intervention known to slow disease progression. Options to assist patients have increased in recent years and now include counselling, nicotine replacement and specific drugs. Some medications with known adverse effects, such as inhaled corticosteroids, seem to be overused, when they have been shown to be efficacious in only a small subset of COPD patients.5 It should be remembered that all medications in COPD are essentially symptom relievers, and do not alter the course of the disease. However, much can be done to improve patients sense of well being and relieve their symptoms. Home oxygen can prolong survival in a selected group; pulmonary rehabilitation programs (including exercise training, nutrition education and psychosocial/behavioural interventions) improve quality of life; and vaccination against influenza and pneumococcal disease can prevent some infective complications. For a selected group, care of exacerbations can be provided at home rather than in hospital, and good follow up care after hospitalisation can reduce readmission rates. In hospital, non invasive ventilation is an effective and increasingly used option for the management of severe exacerbations. There are now even some surgical options (lung volume reduction surgery and lung transplantation) for advanced disease and good palliative care techniques may also be applicable. The Australasian guidelines will be based around a simple acronym COPD-X6 C confirm diagnosis and assess severity O optimise function P prevent deterioration D develop self management and support plan X manage eXacerbations Local programs, projects and resources COPD is one of the five main chronic diseases covered by the NT Preventable Chronic Disease Strategy.7 Preventive work to address smoking, the main remediable cause of COPD, is undertaken by the Tobacco Action Project (TAP) which operates as part of the Alcohol and Other Drugs Program within NT DHCS. TAP pays particular attention to smoking among minors, young adults and Aboriginal and Torres Strait Islander people. The Quitline telephone counselling service is the main form of cessation support available to those wishing to quit smoking. Self help cessation resources are available in a variety of translations. A recent publication contains a bibliography of health promotion materials designed for Indigenous people about tobacco.8 With respect to clinical care, the Centre for Disease Control in Darwin ran a COPD - Clinical Management and Continuity of Care project from 1997-1998. This led to an emphasis on COPD management in the 1998 Remote Area Adult Chronic Disease Management Guidelines, which have been widely adopted in the NT.9 These guidelines also include a focus on helping patients quit smoking. There is a corresponding need to regularly examine guideline implementation. A recent audit of clinical management of stable COPD patients in an East Arnhem community revealed that spirometry was rarely performed and severity rarely assessed (Ian Bilmon, personal communication). Many COPD patients had also not received their influenza and pneumococcal vaccinations. Such regular audits, with feedback of information to providers, will be a feature of the work performed by the NT DHCS Total Recall public health nurses in the Top End. Menzies School of Health Research is also following a cohort of Indigenous Australians living in remote communities who have chronic respiratory disease, and evaluating the efficacy of management guidelines and the role of bacterial infection.10 NT DHCS employs a full time Respiratory Nurse within the NT. This position is Home and Community Care (HACC) funded and performs


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