New guidelines aim to improve management of COPD
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《英国医生杂志》
New guidelines issued jointly this week by the American Thoracic Society and the European Respiratory Society aim to improve provision of information on chronic obstructive pulmonary disease (COPD) to patients and to encourage healthcare professionals to optimise its prevention and treatment.
These are the first guidelines to be developed jointly by the two societies and have been produced in a web based format to make them accessible to patients and professionals throughout the world (www.thoracic.org/COPD/default.asp). They are evidence based updates of previous guidelines that the two societies developed separately in 1995. One part of the guidelines, for health professionals, is designed to improve awareness and early diagnosis of the disease and to promote the idea that it is treatable. A second part, for patients, aims to provide practical, accurate information on all aspects of the disease.
The guidelines were launched at the annual meeting of the American Thoracic Society.
Homer Boushey, professor of medicine at the University of California, San Francisco, and president of the American Thoracic Society, explained that the guidelines were developed because the growing prevalence of the disease and advances in the field warranted an update, particularly in treatment. He warned that the disease was now the fourth leading cause of death in the United States梐nd a major cause of death in many other Western countries. He also said that it is the only major cause of death that is currently increasing in prevalence.
Bartolome Celli, head of pulmonary and critical care medicine at St Elizabeth抯 Medical Center, Boston, and co-chairman of the two society抯 joint committee on COPD, explained that the guidelines aimed to raise awareness of the diseases as well as to improve its management. He said people were currently largely ignorant about the disease.
He said, 揑f you ask the public about SARS everyone knows what it is, even though there have been only 200 deaths throughout the world. But if you ask about COPD, most people think it is a type of car. We need to put COPD on the map because of its huge impact.?/p>
COPD currently accounts for an estimated 150 000 deaths each year in the United States and 1.5 million visits to emergency departments. Figures indicate that 15 million patients are affected by the disease, at an annual estimated cost of $15bn (?.2bn; �12.3bn), Dr Celli reported at the meeting.
The new guidelines define COPD as 揳 preventable and treatable state characterised by airflow limitation that is not fully reversible.?This is a shift away from previous definitions, which represented the disease as a combination of chronic bronchitis, emphysema, and air flow limitation. The guidelines say that a diagnosis of COPD should be considered in any patient who has symptoms of cough, sputum production, or dyspnoea or a history of exposure to cigarette smoke or noxious particles or gases. Diagnosis requires spirometry. If the ratio of forced expiratory volume in one second to forced vital capacity after treatment with bronchodilators is less than 0.7, this confirms that air flow limitation is not fully reversible and indicates a diagnosis of COPD.(Orlando Susan Mayor)
These are the first guidelines to be developed jointly by the two societies and have been produced in a web based format to make them accessible to patients and professionals throughout the world (www.thoracic.org/COPD/default.asp). They are evidence based updates of previous guidelines that the two societies developed separately in 1995. One part of the guidelines, for health professionals, is designed to improve awareness and early diagnosis of the disease and to promote the idea that it is treatable. A second part, for patients, aims to provide practical, accurate information on all aspects of the disease.
The guidelines were launched at the annual meeting of the American Thoracic Society.
Homer Boushey, professor of medicine at the University of California, San Francisco, and president of the American Thoracic Society, explained that the guidelines were developed because the growing prevalence of the disease and advances in the field warranted an update, particularly in treatment. He warned that the disease was now the fourth leading cause of death in the United States梐nd a major cause of death in many other Western countries. He also said that it is the only major cause of death that is currently increasing in prevalence.
Bartolome Celli, head of pulmonary and critical care medicine at St Elizabeth抯 Medical Center, Boston, and co-chairman of the two society抯 joint committee on COPD, explained that the guidelines aimed to raise awareness of the diseases as well as to improve its management. He said people were currently largely ignorant about the disease.
He said, 揑f you ask the public about SARS everyone knows what it is, even though there have been only 200 deaths throughout the world. But if you ask about COPD, most people think it is a type of car. We need to put COPD on the map because of its huge impact.?/p>
COPD currently accounts for an estimated 150 000 deaths each year in the United States and 1.5 million visits to emergency departments. Figures indicate that 15 million patients are affected by the disease, at an annual estimated cost of $15bn (?.2bn; �12.3bn), Dr Celli reported at the meeting.
The new guidelines define COPD as 揳 preventable and treatable state characterised by airflow limitation that is not fully reversible.?This is a shift away from previous definitions, which represented the disease as a combination of chronic bronchitis, emphysema, and air flow limitation. The guidelines say that a diagnosis of COPD should be considered in any patient who has symptoms of cough, sputum production, or dyspnoea or a history of exposure to cigarette smoke or noxious particles or gases. Diagnosis requires spirometry. If the ratio of forced expiratory volume in one second to forced vital capacity after treatment with bronchodilators is less than 0.7, this confirms that air flow limitation is not fully reversible and indicates a diagnosis of COPD.(Orlando Susan Mayor)