Small Airways Disease (SAD): Asthma and COPD

Small airways disease is present across all stages of asthma and COPD^1,2 and an estimated 90% of patients with asthma and symptomatic COPD have small airways disease (SAD)^3,4.

Consultant Respiratory Nurse Emma Rickards talks about the consequences of small airways disease in COPD with reference to early identification, airway obstruction, gas trapping and exacerbation risk.

She then considers the consequences of SAD for individuals with asthma – and how to consider it in clinical practice and within primary care. Nurse Rickards discusses the SADT (Small Airways Dysfunction tool), clinical clues which may help diagnosis and suitable management approaches.

Please also consider watching the on-demand video ‘The Importance of the Small Airways in Asthma and COPD‘ by Dr Rory Chan who presents on the pathophysiology, prevalence, severity and assessment of SAD in respiratory patients.

References

In a prospective cohort study of patients with asthma (N=773) and an observational study of patients with COPD (N=202); symptomatic COPD defined as CAT score ≥10.^1,2

1. Toumpanakis D, Usmani OS. Chin Med J Pulm Crit Care Med. 2023; 1(3): 171–180.

2. Rath AK, et al. Tuberc Respir Dis (Seoul). 2024; 87(2): 165–175

3. Postma DS, et al. Lancet Respir Med. 2019; 7(5): 402–416

4. Crisafulli E, et al. Respiration. 2017; 93: 32–41

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• Emma Rickards

  Respiratory Nurse Consultant

  Read biography
  Emma Rickards

  Respiratory Nurse Consultant Liverpool Heart and Chest Hospital NHS Foundation Trust and Knowsley Community Respiratory Service

  Role and Location
  Respiratory Nurse Consultant at Liverpool Heart and Chest Hospital NHS Foundation Trust and Knowsley Community Respiratory Service.

  Education
  Emma qualified as a nurse with a Bsc (Hons) in Nursing studies, then soon after completed her MSc in Professional Practice with a pathway of difficult asthma. As a keen researcher/practitioner, Emma is a PhD student studying End of Life Care for patients with COPD in ED and as part of her studies has undertaken her MPhil, advanced respiratory nurse practitioner, internship at UCLAN for CLAHRC in Asthma management. Emma is also undertaking her MBA. Emma started her career working at the Northwest Lung Centre working in acute respiratory care.

  Memberships
  Emma is the Respiratory Nurse Acute Care Lead for ARNS.

  Research Interests
  Emma has a passion for research where she was fortunate enough to gain a post at the Clinical Trial Service Unit in Oxford. In 2007, she moved back to the Northwest Lung Centre, but this time worked in respiratory research at the Medicines Evaluation Unit. Emma also has a variety of publications and abstracts surrounding different elements of respiratory care and has presented both nationally and internationally.