Review
Optimizing Chronic Obstructive Pulmonary Disease Management in Primary Care
Abstract
Diagnosis of chronic obstructive pulmonary disease (COPD) in primary care is complex, as many clinical symptoms are similar to asthma and heart disease, which may lead to misdiagnosis and suboptimal disease management. Spirometry is the best method for diagnosing COPD and distinguishing between COPD, asthma, and cardiovascular diseases. Airway obstruction is fully reversible in asthma, but not in COPD, and can be confirmed when the postbronchodilator ratio of forced expiratory volume in one second (FEV1) to forced vital capacity (FVC) is <0.7. Knowledge of COPD treatment guidelines and a proactive attitude toward disease management by primary care physicians are key to improving symptom control and patients' quality of life. Identification of the appropriate drug/inhaler combination, patient education, training on inhaler use followed by regular monitoring, and pulmonary rehabilitation are also vital to successful COPD management. This review outlines steps to aid physicians in devising and implementing an optimal management plan for COPD patients.
Key Points
* Diagnosis of chronic obstructive pulmonary disease (COPD) and differentiation from asthma are the first steps toward COPD management.
* Patient education, training, and monitoring, including good inhaler technique and smoking cessation, are also key to the successful management of this disease.
* A proactive approach by primary care physicians can significantly improve symptom control and the patients' quality of life.
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