Course introduction

Hello. I’m Professor Aziz Sheikh from the Usher Institute at the University of Edinburgh. I’m also director of the National Institute for Health Research, or NIHR, Global Respiratory Health Unit, also known as RESPIRE. Chronic respiratory diseases such as asthma and chronic obstructive pulmonary disease, or COPD, are some of the most common causes of ill health amongst people in our communities. They are particularly prevalent in low-resource settings. There are a range of so-called risk factors which can influence the occurrence of respiratory disease. Smoking and secondhand smoking, indoor air pollutants such as biomass fuel, air pollution, allergens, and occupational agents can all cause or exacerbate respiratory disease.

In this course, we will explain the main symptoms, impact, and risk factors of these most common forms of chronic respiratory disease. There are other respiratory conditions which you may be familiar with, such as respiratory tract infections causing, for example, pneumonia, tuberculosis, which can also become a chronic condition, and lung cancer, the most fatal of all cancers, mainly caused by tobacco smoke and air pollution. These will be briefly explored in this course. This course has a focus on low-resource settings, as there is a link between poverty and respiratory disease. One major factor is the link between disease, nutrition, and exercise.

A further significant factor is that a third of the world’s population use solid fuel derived from plant material or biomass or coal for cooking, heating, or lighting. Low-resource settings may present particular challenges in terms of less well-developed health care systems and limited access to diagnostic and treatment options. It’s important to understand how to adapt advice to the local context, taking account of the global variation in access to care and treatment and the workforce. Chronic respiratory diseases are most often treated in primary care or in a community setting, which places health workers in these settings at the front line. Health care workers need skills in the diagnosis and management of asthma, COPD, and other respiratory conditions in both children and adults.

They also need skills to communicate and support people to live with a chronic condition or self-manage when they may have other illnesses. They may need to support people at the end of their lives. For now, let’s focus on the first week of the course, which will help you to understand the big picture. We will take a global perspective and explore why this topic is so important for every country, community, and for so many families. This will help you get familiar with the different activities you will be doing during the course. After this week, we will explore the most common forms of respiratory disease through case studies, films, podcasts, and key papers to read.

We will offer practical advice and strategies for working with and improving the quality of life for people living with chronic respiratory diseases. We will explore spirituality and care at the end of life. The course has been developed with colleagues working in low-resource settings, some of which are countries involved in the RESPIRE Project. There will be opportunities for you to discuss, adapt, and formulate plans for your own practise and to develop a better understanding of the diagnosis and management of the most common forms of respiratory disease. I hope you enjoy the course, which has been developed collaboratively within the RESPIRE and International Primary Care Respiratory Group networks and includes practical guidance from primary care clinicians working in low-resource settings.

That said, this course is founded on a strong evidence base which will help support your learning. So that’s it for me. Let’s continue on to your first activity.