WNT5A in tumor development and progression: A comprehensive review

The Winter Effect And Other Pressures On COPD Patients: Providing Better Outcomes

This article was funded and reviewed by Sanofi for compliance with the ABPI Code of Practice

As the UK endures another harsh winter, the combination of plummeting temperatures and a surge in respiratory infections – including flu, Covid-19, respiratory syncytial virus (RSV) and norovirus – is placing unprecedented strain on our healthcare system (Campbell, 2024).

Individuals with chronic obstructive pulmonary disease (COPD) are particularly vulnerable, as cold weather exacerbates their symptoms and increases susceptibility to infections (Lima, 2023).

Alarmingly, respiratory diseases now account for more emergency NHS admissions than any other condition (Asthma + Lung UK, 2024), underscoring the critical need for proactive primary and community care interventions to mitigate this seasonal burden.

COPD, a progressive lung disease, affects approximately 2.2% of the UK adult population, equating to over 1.2 million individuals (Mosgrove and Lonergan, 2022). The disease accounts for the second highest number of emergency hospital admissions (National Institute for Health and Care Excellence, 2025), particularly during winter months, exacerbating pressures on the NHS (NHS England, no date).

Late diagnosis and the stark differences between the rich and the poor

Late diagnosis and frequent exacerbations lead to increased healthcare utilisation, including hospital admissions and workforce strain. A recent study demonstrated that late diagnosis, a significant issue in COPD, incurred a 15.7% increase in direct costs per patient during the two years following diagnosis, emphasising the economic impact of delayed detection (NHS England, 2022).

The disparities in COPD prevalence and outcomes are stark between so-called poorer and richer groups of people (Williams et al, 2022).

Individuals residing in socioeconomically disadvantaged areas face higher risks of developing COPD and experiencing severe exacerbations. Factors, such as limited access to healthcare resources, exposure to environmental pollutants and higher smoking rates, contribute to these disparities. Research indicates that neighbourhood disadvantage may reflect the prevalence of stressors that negatively impact COPD health, underscoring the need for targeted interventions in these communities (Williams et al, 2022).

The role of primary and community care, and patient education, in improving outcomes

Primary and community care providers are pivotal in mitigating the impact of COPD.

Early and accurate diagnosis is crucial; for example, utilising spirometry to aid identification of COPD in its initial stages, allowing for timely intervention (Global Initiative for Chronic Obstructive Lung Disease, 2024). Regular patient reviews should be conducted to monitor disease progression and adjust treatment plans accordingly.

Educating patients on self-management strategies, such as recognising early signs of exacerbations and adhering to medication regimens, empowers them to take control of their condition.

Encouraging smoking cessation through support programmes and considering referrals to pulmonary rehabilitation can significantly improve patient outcomes (Man et al, 2023). Additionally, addressing socioeconomic factors by connecting patients with community resources where they may be more comfortable can help alleviate some of the external pressures that exacerbate health disparities (Williams et al, 2022).

Primary and community care providers are incredibly valuable in chronic conditions such as COPD, and effective support can significantly reduce the winter burden of COPD, improving patient outcomes and alleviating pressures on the NHS. Proactive, patient-centred care is essential to navigate the challenges of the winter season.

Collaboration at the heart of improving COPD care

At Sanofi, we are committed to standing with the respiratory health community to address the challenges posed by COPD and ensure equitable respiratory care for all. We aim to highlight and tackle the disparities in respiratory health, advocating for improvements in recognition, diagnosis and quality of care across the UK, so that everyone can breathe equal. We believe that only through true collaboration between patients, health professionals, policymakers and industry, can we create a future where everyone has the opportunity to breathe equal.

References

Asthma + Lung UK (2024) Breathing issues are leading cause of all emergency admissions. Asthmaandlung.Org.Uk, 11 November (accessed 7 March 2025).

Campbell D (2024) Breathing issues cause more emergency NHS admissions than any other condition. Guardian.Co.Uk, 11 November (accessed 7 March 2025).

Global Initiative for Chronic Obstructive Lung Disease (2024) GOLD Spirometry Guide. GICOLD.

Lima C (2023) COPD: Understanding the effects of cold weather on the disease and avoiding exacerbations. Carenity.Co.Uk, 21 November (accessed 7 March 2025).

Man W et al (2023) British Thoracic Society Clinical Statement on pulmonary rehabilitation. Thorax; 78: Supp 5, 2-15.

Mosgrove M, Lonergan T (2022) GOLD 2023: Implications for primary care of patients with COPD in the UK. Primary Care Respiratory Update; 25: 17-22.

National Institute for Health and Care Excellence (2025) Clinical Knowledge Summaries. Chronic obstructive pulmonary disease: How common is it? Cks.Nice.Org.Uk (accessed 7 March 2025).

NHS England (no date) Respiratory disease. England.Nhs.Uk (accessed 7 March 2025).

NHS England (2022) Respiratory high impact interventions. England.Nhs.Uk (accessed 7 March 2025).

Williams PJ et al (2022) Smoking and socioeconomic factors linked to acute exacerbations of COPD: analysis from an Asthma + Lung UK survey. BMJ Open Respiratory Research; 9: 1.

MAT-XU-2500626 (v1.0) March 2025

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Online Pulmonary Rehabilitation Videos Lack Disease-Specific Content

Online pulmonary rehabilitation (PR) videos were assessed to be of moderate quality: they are reasonably easy to understand, but lack important disease-specific information for conditions other than chronic obstructive pulmonary disease (COPD). These were among study findings published in Respiratory Medicine.

Investigators evaluated the content, quality, and comprehensibility of online videos offering PR for chronic lung diseases other than COPD.

The investigators searched the American version of YouTube for videos in English, from 2004 to July 2024, concerning PR on non-COPD conditions (such as interstitial lung disease, pulmonary arterial hypertension, pulmonary fibrosis, long COVID, etc). The first 350 consecutive videos were screened for content and quality and evaluated for understandability and actionability. Videos with paid content, nonfunctional audio, or not related to PR instruction or education were among those excluded.

The 59 videos identified for analysis had PR content that included flexibility, strength training, and/or aerobic training, but with significant heterogeneity. The majority of videos were published after the onset of the COVID-19 pandemic in March 2020 (83%) and did not address specific disease states (85%); 59% were classified as primarily instructional, 41% as educational.

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There is a need for more standardized and disease-specific PR online video resources for non-COPD states.

Videos were assessed for content based on a predefined 30-point scoring matrix derived from PR guidelines. Content quality was evaluated using the modified DISCERN tool, a questionnaire measuring the quality of patient information (score range, 0 to 5); the Global Quality Scale (GQS), which uses a 5-point Likert scale to assess the overall quality of patient information; and the Patient Education Materials Assessment Tools (PEMAT), which considers material to be understandable and actionable if the material meets more than 70% of PEMAT evaluation criteria.   

The mean (SD) content score was 12.1 (5.3) out of 30. Using DISCERN and GQS, the videos were rated as moderate quality with DISCERN, 3/5 (interquartile range [IQR], 3-4) and with GQS, 3/5 (IQR, 2-4). When the videos were assessed using PEMAT for Audiovisual Materials, the 70% threshold was surpassed for mean understandability and actionability.

The primary sources of the 59 online videos reviewed were medical organizations (54%) and user-generated content (31%). Only a few vides targeted specific lung diseases, including idiopathic pulmonary fibrosis (10%; n=6) and COVID-19 sequelae (5%; n=3). Of the videos reviewed, 81% emphasized exercise training and 69% focused on education. The videos most commonly focused on aerobic (63%), resistance (66%), and stretching exercises (61%), with far fewer focusing on inspiratory muscle training (34%) and balance exercises (20%). Safety training related to heart rate or oxygen levels was commonly addressed (64%), although fall risks were not (5%).

Although median video views were 2857 (IQR, 637-10,729), engagement was low  (1.4%; IQR, 1.0-2.7). Total median video duration was 16 (IQR, 9-28) minutes.

Study limitations include the use of "pulmonary rehabilitation" as the only search term, which may have left out other search terms used by patients; the inclusion of only English-language videos; and the subjectivity inherent in the metrics used to evaluate video quality and reliability.

"There is a need for more standardized and disease-specific PR online video resources for non-COPD states," the study authors concluded. "Future efforts should focus on creating high-quality, comprehensible, well-referenced and disease specific PR content to better support patient education and care needs of specific chronic lung disease populations."

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