Prevention of exacerbations: how are we doing and can we do better?

Proceedings of the American Thoracic Society
P S Burge

Abstract

Prevention of exacerbations of chronic obstructive pulmonary disease (COPD) can involve removing the cause or reducing the patient's vulnerability to the cause. This article addresses the following issues: What is the problem during an exacerbation, what are the causes of an exacerbation, what can prevent exacerbations, and who are we? The difference between a patient with COPD during an exacerbation and after recovery is small. It is unlikely that patients with early COPD experience less exposure to exacerbation causes than those with severe disease; it is just that the consequences are more severe for those with severe disease. Interventions that produce small absolute benefits can therefore have a disproportionately large effect on exacerbation reduction. Recognized causes include season, cold weather, pollution events, bacterial infection, viral infection, and treatment withdrawal. Countries with warmer climates have much larger mortality in cold weather than those with colder climates. Reducing exacerbations in more temperate climates may be altered as much by changes in clothing and bedroom heating as by changes in treatment. Taking more exercise in cold weather may be the underlying reason for the reduction of exacerbati...Continue Reading

Citations

Mar 8, 2008·International Journal of Clinical Practice·S Budweiser
Aug 22, 2007·American Journal of Respiratory Cell and Molecular Biology·Akio MatsudaHirohisa Saito
Feb 5, 2008·Respiratory Medicine·Lisette van den BemtChris van Weel
Dec 24, 2008·Journal of Health Services Research & Policy·Richard LewisAnthony Harrison
Jul 17, 2009·Journal of the Royal Society of Medicine·Anthony J Harrison, John Appleby
Jun 25, 2008·Journal of Health Services Research & Policy·Marianna FotakiLiz Smith
May 6, 2015·ERJ Open Research·Jørgen Vestbo, Peter Lange
Dec 16, 2010·Epidemiology and Infection·C R McGowan, A M Viens
Jul 31, 2012·Journal of the Royal Society of Medicine·Jaimie Henry, Nick Nicholas

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