Primary care perspective on chronic obstructive pulmonary disease management

Postgrad Med. 2011 Mar;123(2):145-52. doi: 10.3810/pgm.2011.03.2272.

Abstract

Chronic obstructive pulmonary disease (COPD), which affects > 24 million adults in the United States, is expected to become the third leading cause of mortality by 2030. Because primary care physicians (PCPs) form the frontline in treating patients with COPD, it is vital for them to comprehend the key issues associated with COPD management. The initial step is identifying the "right patient" by making a correct diagnosis, which should involve a targeted respiratory history, physical examination, and spirometry. Following diagnosis, the patient should be treated for the "right reason," with the "right therapy." The right reasons for treating patients diagnosed with COPD include symptom relief, prevention of exacerbations and disease progression, and reduction of mortality. Treatment of patients with COPD through smoking cessation and appropriate medications can help achieve these goals. A range of therapies, such as bronchodilators (β2-agonists and anticholinergics) and inhaled corticosteroids are available for disease management. Tailoring treatment plans, which include both pharmacological and nonpharmacological therapies, to suit each patient's needs will enable PCPs to provide patients with optimal disease control and treat "the right patient for the right reason with the right therapy."

Publication types

  • Review

MeSH terms

  • Adult
  • Bronchodilator Agents / adverse effects
  • Bronchodilator Agents / therapeutic use
  • Humans
  • Primary Health Care / methods*
  • Primary Health Care / standards
  • Pulmonary Disease, Chronic Obstructive / diagnosis
  • Pulmonary Disease, Chronic Obstructive / drug therapy
  • Pulmonary Disease, Chronic Obstructive / therapy*

Substances

  • Bronchodilator Agents