UPDATED guidelines for the management of chronic obstructive pulmonary disease (COPD) include both non-pharmacological and pharmacological strategies to reflect the importance of a holistic approach to clinical care for people living with COPD, according to the authors of a summary published today by the Medical Journal of Australia.
Published by the Lung Foundation Australia and the Thoracic Society of Australia and New Zealand, the guidelines include 26 recommendations addressing:
- case finding and confirming diagnosis – confirmation by spirometry, blood eosinophil levels, behaviour and risk factors (smoking, treatment adherence, self-management skills, physical activity, comorbidities);
- optimising function – non-pharmacological therapies, pharmacological therapies, comorbid conditions, lung volume reduction surgery;
- preventing deterioration – smoking cessation, immunization, oxygen therapy, prophylactic antibiotics, biologic therapies, palliative care, home bilevel ventilation;
- developing a plan of care; and
- managing an exacerbation – pharmacological management, oxygen therapy and non-invasive ventilation.
“About one in 13 Australians over the age of 40 years is estimated to have chronic obstructive pulmonary disease (COPD),” wrote the authors, led by Associate Professor Eli Dabscheck, a respiratory and sleep physician from Melbourne’s Alfred Hospital.
“In 2018, COPD was the leading cause of potentially preventable hospitalisations, the third leading specific cause of total disease burden, and the fifth leading cause of death in Australia. The impact of COPD is even greater among Indigenous Australians compared with non-Indigenous Australians.”
Non-pharmacological therapies for COPD include walking and structured exercise, as well as pulmonary rehabilitation to improve breathlessness, exercise performance, physical activity level and health status. Pharmacological therapies, including short- and long-acting inhaled bronchodilators, inhaled corticosteroids (ICS), and long-acting β-agonists, are evaluated in the guidelines.
The full guidelines are available at https://copdx.org.au/
- Cate Swannell