A new review entitled “Standards of suitability for the management of chronic obstructive respiratory diseases,” published in the journal Multidisciplinary Respiratory Medicine discussed the main topics related to Chronic Obstructive Pulmonary Disease clinical management.
Chronic Obstructive Pulmonary Disease (COPD) is the third cause of mortality and disability-adjusted life years (DALY) worldwide, and leads to significant health, social and economic burdens. Clinicians and patients commonly disregard early symptoms of CPOD because they consider them to be a result of smoking instead of important signs of an incipient disease that becomes irreversible, progressive, and severely disabling. The diagnosis typically only occurs when the disease reaches its later stages.
In the new review, the researchers note that the use of spirometry, the “gold standard” technique for COPD diagnosis, is underutilized. Despite the availability of national and international guidelines, the attitude of clinicians and non-medical health workers in the management of chronic respiratory diseases has been found to be divergent.
During their 2013 conference, the Interdisciplinary Scientific Association for Research in Lung Disease (AIMAR) organized and devised a “Third Consensus Conference” (CC) in Respiratory Medicine. The CC objective was to achieve a consensus in terms of standard management for COPD. Three clinical issues that required immediate attention were raised. These included a more widespread and early diagnosis, adequate treatment of acute and subacute phases, and long-term assistance to chronic patients.
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In their review, the team of researchers Claudio Sanguinetti and colleagues from Italy, explain the methodology applied based on the Italian Health Superior Institute (ISS) for Consensus Conferences where these three parameters were tested.
The Conference was divided into three sessions, and in each session one of the topics was presented and discussed. The participants included hospital and district specialists, general practitioners, and patients’ associations’ representatives. Additionally, an independent jury of health professionals from various backgrounds commented on the results as well. All of these perspectives were taken from the three conference session. All in all, more than one hundred people were involved in the CC.
Results revealed four main topics: spirometry as a critically important tool for COPD management; a diagnostic approach, taking into consideration the different CPOD phenotypes; the essential role of blood gas results for long-term oxygen therapy; and the demand for interventions to decrease the acute exacerbation rates.
Other topics were raised from the discussion, such as the use of noninvasive ventilation; the recognition of which factors affect outcome and mortality in CPOD; and the pharmacological and non-pharmacological options for patients with COPD.
Smoking cessation was found to be insufficiently implemented in health contexts. Uncertainties were raised in factors such as a lack of capacity and standardization of the procedures, unsatisfactory institutional support, and difficulties in assisting chronic patients.
The researchers conclude in their review that a standardized management for COPD is a public health concern that still needs more debate. Health professionals’ operativeness and organizational support to deal with COPD management still needs improvement. Currently, AIMAR in collaboration with other respiratory scientific societies and patients’ associations are organizing more events to debate these questions.