The creation of one of the best regional Chronic Obstructive Pulmonary Disease care in the
world.
The Swedish board of health and welfare have recently published guidelines regarding the treatment
of asthma and chronic obstructive pulmonary disease (COPD) for Swedish healthcare organisation in
their care of these lung diseases. [1] The region of Västra Götaland has already decided to respond
and potentially go beyond these guidelines, setting up the Centre for Chronic Obstructive Pulmonary
Disease.
Chronic Obstructive Pulmonary Disease is a major and increasing global health epidemic that has
received insufficient attention from the health-care profession, governments, and the
pharmaceutical industry. Urgent action is required to recognise the disease, predicted to soon 2020
become one of the major causes of death and disability (no 3), and to develop more effective
prevention and treatment value based strategies.
The disease is described as ”a preventable and treatable disease...characterized by airflow limitation
that is not fully reversible”[2]. ”The airflow limitation is usually progressive and associated with an
abnormal inflammatory response”[2].
There is a progressive and relentless loss of lung function, which results in progressive airflow
limitation, air trapping, and progressive shortness of breath on exertion.
The most common and necessary diagnostic tool seems to be spirometry, as a classification alone has
proved useful in determining health status, predetermine healthcare resources, mortality [3], but
there could be other potential ways to better determine the severity of the disease and measures for
therapy, could be amount and response to medication, physiotherapy, occupational therapy and diet
support [4].
The region of Västra Götaland have decided to make the treatment of COPD as a priority for the
region based on the following:
 Awareness; in medical community and society
 Disease management
o Earlier diagnosis, structured characterisation and longitudinal follow up
o Structured treatment plans, follow-up and deterioration/exacerbation detection,
through self management (COPD school) and healthcare multi-disciplinary team
work
o Public and hospital care working together
 COPD and co-morbidity
o Holistic approach to patient, considering COPD characteristics with co-morbidities
and risk factors, such CV and metabolic disorders !
 Structured follow up
o Customized patients registry: “in-sync” with the Swedish Airway Register to support
structured follow-up on an individual, population/subpopulation basis
o Patient centered care
o Knowing the impact of the the disease and the total burden for the society
 A Knowledge centre
o Combining resources
o Involving research questions
o Clinical trial participation

o Sharing data
A vision for the future of becoming the leading centre in the world in COPD.
In this effort several aims are visible as the creation of ONE virtual COPD centre based on both
hospital competences as a specialist and support team and a working network of nurses,
physiotherapists, occupational therapist, dietiticans and primary care physicians in the region.
Several topics for research could be described and be workable as master thesis work
A. Definition and implementation of Value Based Healthcare (and Person Centered Care) in the
strategic and operational framework for the new COPD-centre.
B. How can the New COPD- centre and it’s value driven approach contribute to decrease in
total burden of disease_ and how to evaluate
C. How to create, incentivise and structure the cooperation in a virtual organisation to improve
the holistic treatment, example of how to cooperate specialist and primary care.
D. Explore/define areas of improved coordination in the management of COPD and selected
(TBD) co-morbitidities
E. How to define rational for / need/benefit of COPD education/awareness programs, in
relation health care professional as well as in relation to community
F. How to make the outcome visible to politicians and other regions
G. How to market the intentions to the rest of the world.
H. How to share data across different organisational borders
References:
1. The Swedish National Board of Health and Welfare; (Guidelines for the care of asthma and
col) Vård vid astma och COL, November 2015. Downloaded from
http://www.socialstyrelsen.se/Lists/Artikelkatalog/Attachments/19949/2015-11-3.pdf
2. Barnes P; Chronic Obstructive Pulmonary Disease; A Growing but Neglected Global Epidemic.
PLoS Med. 2007 May; 4(5): e112.
3. GOLD COPD Guidelines, Classifications and staging 2012.
4. Schols A et al: Nutritional assessment and therapy in COPD: a European Respiratory Society
statement; Eur Respir J 2014; 44: 1504–1520