By Gerard J. Criner, M.D., FACP, FACCP, Chair and Professor of Thoracic Medicine and Surgery at the Lewis Katz School of Medicine at Temple University and Director of the Temple Lung Center
COPD can be complicated to manage, requiring individualized treatment, consistent follow-up, and patient compliance. To help meet this challenge, the Global Initiative for Chronic Lung Disease (GOLD) provides a review of the current recommendations for assessment, diagnosis, and treatment of COPD. Access the GOLD guidelines for free.
The main goals of COPD treatment are to reduce symptoms, prevent exacerbations, limit hospitalizations, and improve quality of life. Key steps include:
Identifying and Reducing COPD Risk Factors
For the patient who smokes, your encouragement and support in quitting is vital. Connecting your patients with a smoking cessation program can offer many benefits. Temple’s Smoking Cessation Center uses both medication and behavioral therapy to help patients reach their goal. Temple can also arrange for lung cancer screening when appropriate. This enables earlier diagnosis, which can lead to improved outcomes.
Prescribing and Monitoring Medications
The GOLD guidelines outline the pharmacologic goals and options. Goals are to reduce symptoms, limit the frequency and severity of exacerbations, and improve health and exercise tolerance. Classes of medications used to treat COPD include beta-2;agonists, anticholinergics, methylxanthines, and combination drugs. The exact regimen should be individualized for each patient based on numerous factors including symptoms, comorbidities, side effects, and patient preference. To help monitor treatment effectiveness, have the patient keep a symptom journal. Another resource is the COPD Co-Pilot app*, available through the Temple Lung Center. This easy-to-use use app enables patients to report symptoms and allows for same-day therapy adjustments.
Providing Education and Support With Regular Followups
For many COPD patients, ongoing support from their health care provider is essential. This includes regular follow-up assessments (including demonstration of inhaler technique) and promotion of good self-management. If available, a pulmonary rehabilitation program can help improve a patient’s physical and psychological condition. In addition, all patients older than 65 should be screened for COPD during annual well-care visits.
Know When to Refer Hard-to-Manage Patients
Indications include deteriorating symptoms, multiple hospitalizations, or complicating comorbidities. For referral to the Temple Lung Center, call 800-TEMPLE-MED.
The economic and social burden of chronic illnesses such as COPD is substantial. But with appropriate care and education, patients can control the disease and lessen their chances of hospitalization.
*Dr. Gerard Criner and Temple University hold a financial interest in the COPD Co-Pilot app.