Francia Health Center, Fuenlabrada, Madrid, Spain.
Expert Rev Respir Med. 2013 Apr;7(2 Suppl):3-15. doi: 10.1586/ers.13.15.
The main objectives in the management of chronic disorders such as chronic obstructive pulmonary disease (COPD) are: to suppress or minimize symptoms; to prevent and reduce exacerbations; to avoid limitations in activities of daily living, and thus to enable the patient to lead a normal, or nearly normal, life. COPD has become a serious public-health concern. The disease, which may be life-threatening if not properly managed, often goes undiagnosed. COPD accounts for significant healthcare, social and personal costs, as it can cause disability and lead to marked impairment in patients' quality of life. The primary goal in the management of COPD should be to maintain patients' clinical stability so as to lessen the impact of the disease. This implies achieving an adequate patient control with as few limitations of everyday activities as possible. In an attempt to optimize their quality of life, patients should be symptom-free or virtually symptom-free. In addition, exacerbations, which involve a high consumption of both healthcare and personal resources, must be prevented. COPD is the fourth leading cause of death among men in Europe. As its prevalence is expected to increase, it might become the third cause of mortality by 2030. In Spain, COPD management has recently been reviewed in the Spanish COPD Guidelines (GesEPOC). The COPD National Health System Strategy, developed by the Spanish Ministry of Health, Social Policy and Equality under the Quality Plan, aims at implementing a set of measures to improve both the efficacy and the quality of healthcare services for patients with COPD.
在慢性疾病(如慢性阻塞性肺疾病)的管理中,主要目标是:抑制或最小化症状;预防和减少恶化;避免日常生活活动受限,从而使患者能够过上正常或几乎正常的生活。COPD 已成为严重的公共卫生问题。如果得不到适当的管理,这种可能危及生命的疾病往往未被诊断出来。COPD 会导致巨大的医疗、社会和个人成本,因为它会导致残疾,并显著降低患者的生活质量。COPD 管理的主要目标应该是保持患者的临床稳定,从而减轻疾病的影响。这意味着要通过尽可能减少日常活动的限制来实现对患者的充分控制。为了优化他们的生活质量,患者应该无明显症状或几乎无症状。此外,还必须预防涉及大量医疗和个人资源消耗的恶化。COPD 是欧洲男性中第四大死亡原因。随着其患病率的预计增加,到 2030 年,它可能成为第三大死因。在西班牙,最近对西班牙慢性阻塞性肺疾病指南(GesEPOC)进行了 COPD 管理审查。在质量计划下,西班牙卫生部、社会政策和平等部制定了国家 COPD 卫生系统战略,旨在实施一系列措施,以提高 COPD 患者医疗服务的效果和质量。