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18 November 2016



What is Chronic Obstruction Pulmonary Disease (COPD)

Chronic obstructive pulmonary disease (COPD) causes substantial morbidity and mortality and may be unrecognized in its early stages. Currently, COPD is becoming a major public health problem with global concern. It is the sixth leading cause of death worldwide and was the third leading cause of death in the United States in 2008. [1] The total number of deaths in the world for COPD will increasing by more than 30% in the next 10 years and this would be the fourth leading cause of death worldwide by 2030. [4] In Asian countries, the number of COPD cases has exceeded three times the total number compared to the rest of the world. In Malaysia, COPD was the fourth leading cause of hospital admissions [6] and was ranked 5th as a burden of disease in 2010. [3] In addition, the prevalence of patients in Malaysia with moderate to severe COPD was 4.7%. [5]

The risk factors of COPD are primarily cigarette smoking, but also included the exposure of patients to noxious particles or gases, recurrent infection, diet, and genetic factors. COPD is often preventable, but not curable. Treatment can control symptoms and slow progression of the disease. This condition was the leading cause of morbidity and mortality worldwide due to the gradual decline in health over the years that greatly affecting their health-related quality of life (HRQOL). [2]

The signs and symptoms of COPD includes chronic bronchitis and emphysema, which both make emptying air from the lungs progressively more difficult to breath and can be associated with cough, mucus production, wheezing, and breathlessness. [2] COPD is significantly under-diagnosed worldwide, including Malaysia.  Many COPD patients present to their doctors with advanced disease at the time of diagnosis. A clinical diagnosis of COPD should be considered in any patient with a history of exposure to risk factors for the disease with symptoms of chronic cough, sputum production or dyspnea. The diagnosis should be confirmed by spirometer. A FEV1/FVC ratio result of less than 0.7 confirms the presence of airflow limitation that is not fully reversible and is currently widely accepted as diagnostic of COPD. If spirometer is unavailable, clinical signs and symptoms, such as progressive shortness of breath and chronic cough with low peak expiratory flow rate, can be used to help with the diagnosis. [6]

By pharmacy Department, Sri Kota Specialist Medical Centre


  1. Miniño, A.M., Xu, J.Q., Kochanek, K.D. 2010, Deaths: Preliminary data for 2008, National Vital Statistics Reports vol 59, no 2, Hyattsville, MD: National Center for Health Statistics.
  2. Lara, J. & Liu X. 2011, Chronic Obstructive Pulmonary Disease among Adults Aged 18 and Over in the United States, 1998–2009. S. DEPARTMENT OF HEALTH AND HUMAN SERVICES, Centers for Disease Control and Prevention National Center for Health Statistics. NCHS Data Brief, No. 63.
  3. Maria, J,, Aslinda, C.M., Nurul Ain, A.R. and Fatim, T.M. 2010, Health-Related Quality of Life of COPD Patients Attending Outpatient Clinic at Institute of Respiratory Medicine, Kuala Lumpur, Malaysia. International Medical Journal Volume 9, Number 1, page 9-13.
  4. World Health Organization (WHO) 2006, Working Together For Health, The World Health Report 2006.
  5. Ayiesah, R., Riza, S. & Choong, Z.Y.2010, A Measure of Health-related Quality of Life (HRQoL) of COPD Patients Following Pulmonary Rehabilitation Program with Two Health Index Questionnaire (SF-36 and SGRQ). Malaysian Journal of Medicine and Health Sciences, 8 (1): 21-26.
  6. Clinical Practice Guidelines: Management of Chronic Obstructive Pulmonary Disease 2nd edition, 2009. Ministry of Health Malaysia.