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慢性阻塞性肺疾病基金会《慢性阻塞性肺疾病袖珍咨询指南》2017年更新版

The 2017 Update to the COPD Foundation COPD Pocket Consultant Guide.

作者信息

Yawn Barbara Bp, Thomashaw Byron, Mannino David M, Han MeiLan K, Kalhan Ravi, Rennard Stephen, Cerrata Scott, Crapo James D, Wise Robert

机构信息

Department of Family and Community Health, University of Minnesota School of Medicine, Minneapolis.

Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York.

出版信息

Chronic Obstr Pulm Dis. 2017 Jul 15;4(3):177-185. doi: 10.15326/jcopdf.4.3.2017.0136.

Abstract

The COPD Foundation Pocket Consultant Guide (PCG) was first released in 2007 as a practice tool for use at point of service for clinicians, especially primary care clinicians diagnosing and treating patients with chronic obstructive pulmonary disease (COPD). Over the years, the PCG has been supplemented with a mobile app that presents the tool in an online smart phone accessible version that also allows the clinician to enter patient specific data for guidance to next steps of diagnosis or management. In November 2016, a new update of the PCG was released that incorporates a flow diagram for stepped care that includes the newest recommendation for diagnosis, assessment and treatment; including the broad use of dual bronchodilator therapy and consideration of asthma COPD overlap syndrome (ACOS). The current controversy regarding when to add inhaled corticosteroids (ICSs) is addressed to support clinical decision making. The PCG comes in 2 versions, one with generic names for COPD drugs available in the United States and one with trade names for those drugs. The update continues to recommend spirometry for those at highest risk, also emphasizing the need to assess symptoms, exacerbation risks and comorbidity before selecting appropriate non-pharmacological as well as pharmacological therapy. The tool is designed to facilitate COPD management in daily practice.

摘要

慢性阻塞性肺疾病基金会袖珍咨询指南(PCG)于2007年首次发布,作为一种实践工具供临床医生,尤其是诊断和治疗慢性阻塞性肺疾病(COPD)患者的初级保健临床医生在服务点使用。多年来,PCG已通过一款移动应用程序进行补充,该应用程序以在线智能手机可访问版本呈现该工具,还允许临床医生输入患者特定数据以指导诊断或管理的下一步操作。2016年11月,发布了PCG的新更新版本,其中纳入了阶梯式治疗流程图,包括诊断、评估和治疗的最新建议;包括广泛使用双联支气管扩张剂治疗以及考虑哮喘-慢性阻塞性肺疾病重叠综合征(ACOS)。解决了当前关于何时添加吸入性糖皮质激素(ICS)的争议,以支持临床决策。PCG有两个版本,一个版本使用美国可用的COPD药物通用名,另一个版本使用这些药物的商品名。该更新继续推荐对高危人群进行肺功能测定,同时强调在选择适当的非药物以及药物治疗之前,需要评估症状、加重风险和合并症。该工具旨在促进日常实践中的COPD管理。

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