The American College of Physicians (ACP), American College of ChestPhysicians (ACCP), American Thoracic Society (ATS), and EuropeanRespiratory Society (ERS) have released a joint clinical practiceguideline on diagnosing and treating stable chronic obstructivepulmonary disease (COPD) in Annals of Internal Medicine , ACP's flagship journal. ACP convened the four organizations,which represent more than 170,000 physicians from around the world,to develop the joint guideline. "This clinical practice guideline aims to help clinicians todiagnose and manage stable COPD, prevent and treat exacerbations,reduce hospitalizations and deaths, and improve the quality of lifeof patients with COPD," said lead author Amir Qaseem, MD, FACP,PhD, Director of Clinical Policy, American College of Physicians."It is important for patients with COPD to stop smoking and forphysicians to help their patients to quit smoking." COPD occurs predominantly in cigarette smokers. COPD symptomsinclude chronic cough, wheezing, shortness of breath, orsignificant activity limitation. The clinical practice guideline includes the followingrecommendations: ACP, ACCP, ATS, and ERS recommend that spirometry should beobtained to diagnose airflow obstruction in patients withrespiratory symptoms.
"While targeted use of spirometry for diagnosis of airflowobstruction is beneficial for patients with respiratory symptoms,particularly dyspnea, it does not appear to have an independentinfluence on the likelihood of quitting smoking or maintainingabstinence," noted Nicola A. Hanania, MD, MS, FCCP, Chair, AirwaysDisorders NetWork, American College of Chest Physicians. ACP, ACCP, ATS, and ERS recommend that spirometry should not beused to screen for airflow obstruction in individuals withoutrespiratory symptoms. "The routine use of spirometry for patients without respiratorysymptoms could lead to unnecessary testing, increased costs,unnecessary disease labeling, and the harms of long-term treatmentwith no known preventive effect on avoiding future symptoms," saidGerard Criner, MD, Professor of Medicine, Temple University, andpast chair of the American Thoracic Society's Assembly on ClinicalProblems.
For stable COPD patients with respiratory symptoms and FEV1 (forcedexpiratory volume in 1 second) between 60 percent and 80 percentpredicted, ACP, ACCP, ATS, and ERS suggest that treatment withinhaled bronchodilators may be used. (FEV1 is measured byspirometry, a breathing test that measures how much air a personcan blow out in one second.) For stable COPD patients with respiratory symptoms and FEV1 lessthan 60 percent predicted, ACP, ACCP, ATS, and ERS recommendtreatment with inhaled bronchodilators. ACP, ACCP, ATS, and ERS recommend that clinicians prescribemonotherapy using either long-acting inhaled anticholinergics orlong-acting inhaled beta agonists for symptomatic patients withCOPD and FEV1 less than 60 percent predicted. Clinicians shouldbase the choice of specific monotherapy on patient preference,cost, and adverse effect profile. ACP, ACCP, ATS, and ERS suggest that clinicians may administercombination inhaled therapies (long acting inhaledanticholinergics, long-acting inhaled beta agonists, or inhaledcorticosteroids) for symptomatic patients with stable COPD and FEV1less than 60 percent predicted.
ACP, ACCP, ATS, and ERS recommend that clinicians should prescribepulmonary rehabilitation for symptomatic patients with an FEV1 lessthan 50 percent predicted. Clinicians may consider pulmonaryrehabilitation for symptomatic or exercise-limited patients with anFEV1 greater than 50 percent predicted. ACP, ACCP, ATS, and ERS recommend that clinicians should prescribecontinuous oxygen therapy in patients with COPD who have severeresting hypoxemia. Additional References Citations. I am a professional writer from Home & Garden, which contains a great deal of information about gas grill grilling , greyhound dog collars, welcome to visit!
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