The Overlap Syndrome of Asthma and COPD

The asthma-COPD overlap syndrome presents itself in patients where the asthma is not controlled despite seemingly appropriate measures or a patient who is a smoker and treated as COPD but also has asthmatic features. The asthma-COPD overlap syndrome is more common in the elderly. Such patients are of importance to diagnose because they have a high disease burden compared to asthma alone or COPD alone. Patients with both asthma and COPD should be identified earlier, as these patients have an increased risk for frequent exacerbations and therefore their treatment and follow-up should be optimised before hospital discharge. Also rehabilitation immediately after an exacerbation has been shown to be safe and effective to prevent further exacerbations requiring hospitalisation.

Pulmonary Rehabilitation

Pulmonary rehabilitation identifies and treats the systemic effects of the disease and the positive outcomes are realised without demonstrable improvements in lung function. It is multidisciplinary, patient centred and provides a comprehensive assessment upon which the three components of exercise training, self-management education, and psychosocial/ behaviour intervention are conducted over a period lasting 6 to 12 weeks. Pulmonary rehabilitation administered after hospital admission for an exacerbation was shown to be able to improve quality of life, improve exercise capacity, and also reduce re-exacerbation and hospital admission. Self-management education may promote long-term adherence to the exercise program.