Recent updates in chronic obstructive pulmonary disease

ABSTRACT

Chronic obstructive pulmonary disease (COPD), characterized by chronic airways inflammation and progressive airflow limitation, is a common, preventable and treatable disease. Worldwide, COPD is a major cause of morbidity and mortality; smoking tobacco is the most important risk factor. This translational review of recent updates in COPD care for the primary care audience, includes recommendations from the 2015 Global Initiative for chronic obstructive lung disease (GOLD) report on diagnosis, pharmacological and non-pharmacological treatment, prevalence of comorbidities, management of exacerbations and the asthma and COPD overlap syndrome, with a focus on the importance and benefit of physical activity and exercise in COPD patients. Exacerbations and comorbidities contribute to the overall severity of COPD in individual patients. Management of exacerbations includes reducing the impact of the current exacerbation and preventing development of subsequent episodes. Healthcare professionals need to be alert to comorbidities, such as cardiovascular disease, anxiety/depression, lung cancer, infections and diabetes, which are common in COPD patients and can have a significant impact on HRQoL and prognosis. Pulmonary rehabilitation is recommended by a number of guidelines for all symptomatic COPD patients, regardless of severity, and involves exercise training, patient education, nutritional advice and psychosocial support. At all stages of COPD, regular physical activity and exercise can aid symptom control, improve HRQoL, reduce rates of hospitalization, and improve morbidity and respiratory mortality. Healthcare professionals play a pivotal role in improving HRQoL and health-related outcomes in COPD patients to meet their specific needs and in providing appropriate diagnosis, management and advice on smoking cessation.

KEYWORDS:

• Chronic obstructive pulmonary disease
• smoking cessation
• comorbidities
• exacerbations
• physical activity
• exercise

Declaration of interest

Medical writing assistance, supported financially by Boehringer Ingelheim, was provided by Gill Sperrin, CBiol, MSB, CMPP, of Envision Scientific Solutions during the preparation of this Review. Boehringer Ingelheim was given the opportunity to check the data used in the manuscript for factual accuracy only. The author was fully responsible for all content and editorial decisions, was involved at all stages of manuscript development and approved the final version of the review that reflects the author’s interpretation and conclusions. C Garvey reports non-financial support from Boehringer Ingelheim for the preparation of this manuscript. The author has other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from that disclosed.