Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps University of Marburg, Member of the German Center for Lung Research (DZL), Marburg, Germany.
Son Pisà Primary Health Care Centre, Instituto de Investigación Sanitaria de Las Islas Baleares (IdISBa), Palma de Mallorca, Spain.
Respir Med. 2020 May;166:105938. doi: 10.1016/j.rmed.2020.105938. Epub 2020 Mar 21.
Chronic obstructive pulmonary disease (COPD) is currently a leading cause of death worldwide, and its burden is expected to rise in the coming years. Common COPD symptoms include dyspnea, cough and/or sputum production. Some patients may experience acute worsening of symptoms (known as an exacerbation), and therefore require additional therapy. Exacerbations are mainly triggered by respiratory infections and environmental factors. Healthcare professionals face many challenges in COPD management, including the heterogeneity of the disease and under-reporting of symptoms. The authors review these challenges and provide recommendations for the best methods to assess COPD. The goals of COPD treatment include recognising the impact that both symptoms and exacerbations have on patients' lives when considering optimal patient-focused management. The review discusses the need for COPD management strategies to include both pharmacologic and non-pharmacologic approaches and provides recommendations for monitoring treatment outcomes and adjusting management strategies accordingly. Novel treatment strategies including precision medicine and point-of-care testing are also discussed.
慢性阻塞性肺疾病(COPD)目前是全球主要的致死原因之一,预计在未来几年其负担将会增加。COPD 的常见症状包括呼吸困难、咳嗽和/或咳痰。一些患者可能会经历症状的急性恶化(称为加重),因此需要额外的治疗。加重主要由呼吸道感染和环境因素引发。医疗保健专业人员在 COPD 管理方面面临许多挑战,包括疾病的异质性和症状报告不足。作者回顾了这些挑战,并为评估 COPD 的最佳方法提供了建议。COPD 治疗的目标包括在考虑最佳以患者为中心的管理时,认识到症状和加重对患者生活的影响。本综述讨论了 COPD 管理策略需要同时包括药物和非药物方法,并就监测治疗效果和相应调整管理策略提出了建议。还讨论了包括精准医学和即时检测在内的新型治疗策略。