Son Pisà Primary Health Care Centre, Balearic Health System, Mallorca, Spain.
Primary Care Chronic Respiratory Research Unit, Instituto de Investigación Sanitaria de las Islas Baleares (IdISBa), Mallorca, Spain.
NPJ Prim Care Respir Med. 2021 Sep 9;31(1):41. doi: 10.1038/s41533-021-00254-8.
Primary care physicians (PCPs) play a crucial role in the diagnosis and management of chronic obstructive pulmonary disease (COPD). By working together with patients to target exertional breathlessness and increase physical activity, PCPs have an important role to play, early in the disease course, in improving patient outcomes in both the short and long term. In this article, we consider how physical activity affects disease progression from the PCP perspective. We discuss the role of pharmacological therapy, the importance of an holistic approach and the role of PCPs in assessing and promoting physical activity. The complexity and heterogeneity of COPD make it a challenging disease to treat. Patients' avoidance of activity, and subsequent decline in capacity to perform it, further impacts the management of the disease. Improving patient tolerance of physical activity, increasing participation in daily activities and helping patients to remain active are clear goals of COPD management. These may require an holistic approach to management, including pulmonary rehabilitation and psychological programmes in parallel with bronchodilation therapy, in order to address both physiological and behavioural factors. PCPs have an important role to optimise therapy, set goals and communicate the importance of maintaining physical activity to their patients. In addition, optimal treatment that addresses activity-related breathlessness can help prevent the downward spiral of inactivity and get patients moving again, to improve their overall health and long-term prognosis.
初级保健医生（PCP）在慢性阻塞性肺疾病（COPD）的诊断和管理中起着至关重要的作用。通过与患者合作，针对运动性呼吸困难并增加体力活动，PCP 在疾病早期对改善患者的短期和长期预后具有重要作用。在本文中，我们从 PCP 的角度考虑体力活动如何影响疾病进展。我们讨论了药物治疗的作用、整体方法的重要性以及 PCP 在评估和促进体力活动方面的作用。COPD 的复杂性和异质性使其成为一种具有挑战性的治疗疾病。患者避免活动，以及随后活动能力下降，进一步影响了疾病的管理。提高患者对体力活动的耐受性，增加日常活动的参与度，并帮助患者保持活跃，这是 COPD 管理的明确目标。为了解决生理和行为因素，这些可能需要整体管理方法，包括肺康复和心理计划，以及支气管扩张治疗。PCP 在优化治疗、设定目标和向患者传达保持体力活动的重要性方面发挥着重要作用。此外，针对与活动相关的呼吸困难的最佳治疗可以帮助防止不活动的恶性循环，并使患者再次活动，以改善他们的整体健康和长期预后。
