“First, I think that the fact these guidelines
have been prepared at all is good recognition
that COPD is an important problem,” Rennard,
Larson Professor of Medicine in the Pulmonary
and Critical Care Medicine Section of the
Department of Internal Medicine at the
University of Nebraska Medical Center, says.
“Second, they talk about the use of spirometry—which is key. It’s not routinely done, and as a result, there’s both under- diagnosis and over-diagnosis of COPD. It’s very important to have the diagnosis be right.” Spirometry is a pulmonary function test used to diagnosed COPD by measuring how much (volume) and how fast (flow) you can move air in and out of your lungs.
The full report is titled, “Diagnosis and Management of Stable Chronic Obstructive Pulmonary Disease: A Clinical Practice Guideline Update from the American College of Physicians, American College of Chest Physicians, American Thoracic Society, and European Respiratory Society.”
From the Guidelines:
“A good indicator of risk for COPD is having smoked the equivalent of 1 pack per day for 55 years (55 pack-years). People who have never smoked or wheezed are unlikely to have COPD. The evidence does not support treating patients without COPD symptoms, even those with abnormal breathing test results, because such treatment does not improve outcomes.” These guidelines considered studies only published in 2007 through 2009.
The third reason, according to Rennard, is that the guidelines provide strong evidence of the importance of pulmonary rehabilitation.
“Pulmonary rehabilitation is way underutilized, because in part it’s not widely available, but it needs to be,” he says.
Pulmonary Rehabilitation is a program designed for individuals with COPD to help them lead satisfying lives and bring them to their highest functional capacity. Pulmonary Rehabilitation is aimed at decreasing respiratory symptoms and complications while encouraging self-management and control over daily functioning. It also helps individuals with COPD improve their physical condition and exercise performance through components of the program such as exercise, breathing retraining, education and nutrition counseling.
“There is very good evidence that rehab does great things, but it’s not widely available. The COPD community really needs to mobilize on the issue of rehab,” Rennard says. “If we pride ourselves on the health care system and COPD is a major public health problem, why is rehab not available? This is not controversial. Most people with the condition will say there’s no question that rehab is a wonderful thing.”
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