COPD: Understanding chronic obstructive pulmonary disease and its home healthcare support

Chronic obstructive pulmonary disease (COPD) is a debilitating and underdiagnosed chronic respiratory disease. It represents a major public health problem, as it is the fourth leading cause of death worldwide¹. Characterized by permanent and progressive airway obstruction, COPD progresses slowly, initially manifesting as a chronic cough and shortness of breath that is disproportionate to the level of exertion. It cannot be cured, but its progression can be slowed with appropriate treatment. Air Liquide Healthcare, a leader in home healthcare for respiratory conditions, supports people living with this disease in their daily lives with the goal of improving their quality of life. This page offers a comprehensive guide to understanding COPD, its symptoms, its diagnosis (via spirometry), available treatments (smoking cessation, bronchodilators, oxygen therapy, NIV), and personalized daily care support.

What is COPD?

Definition of Chronic Obstructive Pulmonary Disease

Chronic obstructive pulmonary disease, or COPD, is a particularly debilitating chronic respiratory disease characterized by permanent, slow, and progressive obstruction of the airways and lungs. Specifically, the walls of the bronchi and bronchioles thicken, and the cells produce excessive amounts of mucus, leading to a narrowing and obstruction of the airways. In addition, the pulmonary alveoli become distorted and gradually lose their elasticity. Unlike asthma, where bronchial obstruction can be completely reversed after inhaling a bronchodilator, the reduction in expiratory flow in COPD is not fully reversible. This insidious condition progresses slowly and worsens over time.

COPD by the numbers: prevalence and global impact

COPD represents a major public health problem worldwide. It is currently the fourth leading cause of death globally, causing approximately 3.5 million deaths per year¹, which accounts for nearly 5% of global mortality in 2021. In a European country like France, this condition affects approximately 3.5 million people and is responsible for about 18,000 deaths each year². Prevalence increases with age, and the disease now affects an increasing number of women, who account for 40 to 45% of patients due to the rise in smoking among women³. Unfortunately, this disease remains largely underdiagnosed, as it is estimated that about two-thirds of patients are completely unaware that they have it².

Symptoms of COPD

The progression of COPD is marked by debilitating symptoms that affect respiratory function.

Early signs: cough, phlegm, shortness of breath

The disease progresses silently for many years without triggering any obvious symptoms. In smokers over the age of 40, the very first signs often take the form of a chronic cough, accompanied by phlegm or sputum, which occurs particularly in the morning upon waking. This so-called “smoker’s cough” is very often mistakenly dismissed as trivial by patients. Shortness of breath, medically known as dyspnea, then sets in very gradually. It initially appears during intense physical exertion or when walking briskly, then progressively becomes a problem for the patient even during increasingly minor, everyday activities.

Progression of symptoms across stages

Over time, the narrowing of the bronchi worsens and shortness of breath becomes significantly more severe, eventually occurring even at rest. Patients then experience episodes of exacerbations, characterized by a sudden worsening of cough, phlegm, and dyspnea, often triggered by simple infections. At a very advanced stage, this damage leads to chronic respiratory failure with a persistent lack of oxygen in the blood, requiring respiratory support.

Diagnosis and progression of COPD

The earlier the diagnosis, the better the chances of slowing the disease’s progression by accurately determining its stage.

Diagnosis via spirometry: FEV1 and FVC

A definitive diagnosis of COPD must be based on pulmonary function testing, specifically spirometry. This quick medical test very accurately measures a patient’s lung capacity and bronchial airflow. In particular, it assesses forced vital capacity (FVC) and forced expiratory volume in one second (FEV₁). Spirometry reveals an obstructive ventilatory disorder that persists, at least partially, despite the inhalation of a bronchodilator medication. This confirms the permanent and irreversible narrowing of the airways.

The 4 Stages of COPD according to GOLD

Based on the measured FEV1 value—and thus the severity of bronchial obstruction—the leading international organization GOLD (Global Initiative for Chronic Obstructive Lung Disease) has defined the progression of the disease according to four stages of increasing severity. Stage 1 describes mild obstruction, where FEV1 is greater than or equal to 80% of the normal peak expiratory volume. Stage 4 indicates very severe obstruction with an FEV1 of less than 30%⁷.

COPD treatments

The management of COPD aims to reduce daily symptoms and prevent sudden exacerbations to improve patients’ quality of life. While treatments cannot cure COPD, they can slow the decline in lung function.

Recommended vaccinations (flu, pneumococcal, COVID-19)

Patients with COPD are more vulnerable to respiratory infections, which are major causes of exacerbations. Exacerbations are defined as increased dyspnea—when shortness of breath becomes severe following minimal exertion—accompanied by an increase in coughing and copious sputum production. It is strongly recommended that people living with COPD get vaccinated against the flu every year and protect themselves against pneumococcal disease, the COVID-19 virus, and RSV.

Adapting your environment and lifestyle

Exposure to tobacco smoke and indoor pollution should be minimized as much as possible. Special attention should also be paid to ensuring a balanced diet to prevent malnutrition or, conversely, excess weight.

How Air Liquide Healthcare supports people living with COPD

Recognized expertise in home respiratory care

Air Liquide Healthcare combines the expertise of its teams with the power of digital solutions to personalize care. Specifically, the analysis of remote monitoring data, combined with human intervention, enables us to detect early signs of treatment discontinuation or clinical deterioration, side effects, or difficulties related to the use of medical devices. All of this information is shared with the patient’s physician.

Moving away from an approach that has historically focused on medical equipment, Air Liquide Healthcare is committed to offering support plans centered on the person living with a chronic condition.

Our services: oxygen therapy, ventilation, personalized care

In accordance with the issued prescription, these home-based treatments include the provision of medical devices (oxygen concentrators, ventilators, respirators), training in their use, and support for patients and their families to ensure proper adherence to therapy and manage its impact on daily life. This enables patients to take an active role in their treatment throughout their lives. Once a diagnosis and treatment plan have been established by a physician, long-term treatment requires patient support, provided by qualified nurses or technicians either in person or remotely through the increased use of digital solutions. Personalized care plans provide the support each patient needs, when they need it. Through multidisciplinary teams of experts (pharmacists, nurses, nutritionists, and technicians), Air Liquide Healthcare aims to enhance patients’ independence and improve their quality of life by ensuring treatment adherence to prevent the risk of relapse or rehospitalization.

Coordinated care with the prescribing pulmonologist

Our care model is based on very close collaboration with healthcare professionals. Information is continuously shared with them through regular meetings and access to a digital platform that consolidates remote monitoring alerts and all our visit reports or communications with patients, enabling us to work in perfect coordination. This seamless communication and close patient monitoring are designed to reduce their daily workload. Non-essential visits to the hospital or doctor’s office are avoided, allowing medical teams to focus on their most critical clinical tasks.