EMERGING TRENDS IN HIGH-RISK PULMONARY CARE: PATIENT-LED SCREENING AND NURSING ROLES

Abstract

Chronic respiratory diseases are long-term disorders affecting the airways, lung parenchyma, pulmonary circulation, and other structures involved in respiration. They include asthma, chronic obstructive pulmonary disease or COPD, bronchiectasis, occupational lung disease, interstitial lung disease, pulmonary hypertension, cystic fibrosis, and chronic respiratory failure. The global burden of these diseases remains substantial. The World Health Organization reported that COPD caused approximately 3.4 million deaths in 2023 and remained the third leading cause of death worldwide. Nearly 90% of deaths among people younger than 70 years occurred in low- and middle-income countries. Limited access to spirometry, inhaled medicines, rehabilitation, and specialist services contributes to underdiagnosis and inadequate treatment in these settings.

High-risk pulmonary care is moving from episodic, clinician-initiated encounters toward a longitudinal model in which patients, families, nurses, primary-care teams, and specialists share responsibility for recognizing deterioration early. This shift is driven by persistent under-recognition of chronic respiratory disease, recurrent exacerbations, multimorbidity, unequal access to spirometry and specialty services, and the growing availability of digital tools. The World Health Organization (WHO, 2025a) emphasizes that effective prevention, diagnosis, treatment, and monitoring of asthma and chronic obstructive pulmonary disease (COPD) are necessary to reduce avoidable illness and death, particularly where resources are constrained.