Early management of COPD: where are we now and where do we go from here? A Delphi consensus project

International Journal of Chronic Obstructive Pulmonary Disease
Fabiano Di MarcoMauro Carone

Abstract

There is a lack of consensus on the most appropriate early diagnostic strategy, criteria for early access to treatment and follow-up approach for patients with COPD. A Delphi consensus project investigated the early management of COPD. We formulated two questionnaires for completion by pneumologists in Italy. A total of 207 specialists completed questionnaire 1 and 184 of them questionnaire 2, between November 2016 and October 2017. Early diagnosis of COPD was considered uncommon for 93.2% of the expert panel. Regardless of the definition of "early diagnosis" - a diagnosis made before the clinical manifestation of the disease for most responders (60.4%) - experts were confident of the positive effects of early disease management, which they consider is effective in modifying the natural history of the disease. Lack of awareness of the disease was considered the first limiting factor to early COPD management for 78% of respondents. The most effective steps to reduce functional decline were considered to be smoking cessation, followed by long-acting β2-agonist (LABA)/long-acting muscarinic antagonist (LAMA), LAMA, LABA, and finally inhaled corticosteroid/LABA (P<0.01 for each paired comparison). Specialists considered it "inappro...Continue Reading

Citations

May 28, 2019·MMW Fortschritte der Medizin·Adrian Gillissen
Jun 7, 2019·Multidisciplinary Respiratory Medicine·Marco CandelaGiacomo Curradi
May 28, 2019·MMW Fortschritte der Medizin·Adrian Gillissen
Dec 4, 2020·European Respiratory Review : an Official Journal of the European Respiratory Society·Maria Eugenia Laucho-Contreras, Mark Cohen-Todd
Feb 26, 2021·Annals of the American Thoracic Society·Anita L OhUNKNOWN SPIROMICS Smoking Resilience Group
Mar 7, 2021·International Journal of Clinical Practice·Juan Manuel Arriero-MarínJosé A Quesada
Aug 7, 2020·Respiration; International Review of Thoracic Diseases·Marina AttanasiUNKNOWN Collaborators for the RECOVER Investigators Study Group

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