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Chronic Obstructive Pulmonary Disease: official diagnosis and treatment guidelines of the Czech Pneumological and Phthisiological Society; a novel phenotypic approach to COPD with patient-oriented care

V. Koblizek, J. Chlumsky, V. Zindr, K. Neumannova, J. Zatloukal, J. Zak, V. Sedlak, J. Kocianova, J. Zatloukal, K. Hejduk, S. Pracharova

. 2013 ; 157 (2) : 189-201.

Language English Country Czech Republic

Document type Journal Article, Practice Guideline

Persistent link   https://www.medvik.cz/link/bmc14056219

BACKGROUND: COPD is a glo Bal concern. Currently, several sets of guidelines, statements and strategies to managing COPD exist around the world. METHODS: The Czech Pneumological and Phthisiological Society (CPPS) has commissioned an Expert group to draft recommended guidelines for the management of sta Ble COPD. Su Bsequent revisions were further discussed at the National Consensus Conference (NCC). Reviewers' comments contri Buted to the esta Blishment of the document's final version. DIAGNOSIS: The hallmark of the novel approach to COPD is the integrated evaluation of the patient's lung functions, symptoms, exacer Bations and identifications of clinical phenotype(s). The CPPS defines 6 clinically relevant phenotypes: frequent exacer Bator, COPD-asthma overlap, COPD- Bronchiectasis overlap, emphysematic phenotype, Bronchitic phenotype and pulmonary cachexia phenotype. TREATMENT: Treatment recommendations can Be divided into four steps. 1(st) step = Risk exposure elimination: reduction of smoking and environmental to Bacco smoke (ETS), decrease of home and occupational exposure risks. 2(nd) step = Standard treatment: inhaled Bronchodilators, regular physical activity, pulmonary reha Bilitation, education, inhalation training, comor Bidity treatment, vaccination. 3(rd) step = Phenotype-specific therapy: PDE4i, ICS+LA BA, LVRS, BVR, AAT augmentation, physiotherapy, mucolytic, A BT. 4(th) step = Care for respiratory insufficiency and terminal COPD: LTOT, lung transplantation, high intensity-NIV and palliative care. CONCLUSION: Optimal treatment of COPD patients requires an individualised, multidisciplinary approach to the patient's symptoms, clinical phenotypes, needs and wishes. The new Czech COPD guideline reflects and covers these requirements.

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$a BACKGROUND: COPD is a glo Bal concern. Currently, several sets of guidelines, statements and strategies to managing COPD exist around the world. METHODS: The Czech Pneumological and Phthisiological Society (CPPS) has commissioned an Expert group to draft recommended guidelines for the management of sta Ble COPD. Su Bsequent revisions were further discussed at the National Consensus Conference (NCC). Reviewers' comments contri Buted to the esta Blishment of the document's final version. DIAGNOSIS: The hallmark of the novel approach to COPD is the integrated evaluation of the patient's lung functions, symptoms, exacer Bations and identifications of clinical phenotype(s). The CPPS defines 6 clinically relevant phenotypes: frequent exacer Bator, COPD-asthma overlap, COPD- Bronchiectasis overlap, emphysematic phenotype, Bronchitic phenotype and pulmonary cachexia phenotype. TREATMENT: Treatment recommendations can Be divided into four steps. 1(st) step = Risk exposure elimination: reduction of smoking and environmental to Bacco smoke (ETS), decrease of home and occupational exposure risks. 2(nd) step = Standard treatment: inhaled Bronchodilators, regular physical activity, pulmonary reha Bilitation, education, inhalation training, comor Bidity treatment, vaccination. 3(rd) step = Phenotype-specific therapy: PDE4i, ICS+LA BA, LVRS, BVR, AAT augmentation, physiotherapy, mucolytic, A BT. 4(th) step = Care for respiratory insufficiency and terminal COPD: LTOT, lung transplantation, high intensity-NIV and palliative care. CONCLUSION: Optimal treatment of COPD patients requires an individualised, multidisciplinary approach to the patient's symptoms, clinical phenotypes, needs and wishes. The new Czech COPD guideline reflects and covers these requirements.
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