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

Fabiano Di Marco1 Department of Health Sciences, University of Milan, Respiratory Unit, Papa Giovanni XXIII Hospital, Bergamo, Italy, [email protected]Correspondence[email protected]

Piero Balbo2 SC Malattie dell’Apparato Respiratorio, AOU Maggiore della Carità, Novara, Italy

Francesco de Blasio3 Respiratory Medicine and Pulmonary Rehabilitation Section, Clinic Center S.p.A. Private Hospital, Department of Medicine and Health Sciences “V Tiberio”, University of Molise, Campobasso, Italy

Vittorio Cardaci4 Unit of Pulmonary Rehabilitation, IRCCS “San Raffaele Pisana”, Rome, Italy

Nunzio Crimi5 Unità Operativa Complessa di Pneumologia e Allergologia, Policlinico Rodolico Vittorio Emanuele, Università di Catania, Catania, Italy

Giuseppe Girbino6 Dipartimento di Scienze Biomediche, Odontoiatriche e delle Immagini Morfologiche e Funzionali (BIOMORF), Università degli Studi di Messina, Messina, Italy

Girolamo Pelaia7 Department of Medical and Surgical Sciences, Unit of Respiratory Diseases, University Magna Graecia of Catanzaro, Catanzaro, Italy

Pietro Pirina8 Respiratory Unit, AOU Sassari, Sassari, Italy

Pietro Roversi9 Azienda Ospedaliera Universitaria, Policlinico di Modena, Modena, Italy

Pierachille Santus10 Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy;11 Division of Respiratory Diseases “L. Sacco” Hospital, ASST Fatebenefratelli Sacco, Milan, Italy

Nicola Scichilone12 Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), University of Palermo, Palermo, Italy

Alessandro Vatrella13 Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Salerno, Italy

Patrizio Pasqualetti14 Fondazione Fatebenefratelli per la Ricerca e la Formazione Sanitaria e Sociale, Rome, Italy

Mauro Carone15 Istituti Clinici Scientifici Maugeri, IRCCS di Cassano delle Murge, Cassano delle Murge (BA), Italy

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Figures & data

Figure 1 Level of consensus on the early management of COPD.

Abbreviations: GP, general practitioner; IPRAS, Inter-percentile Range Adjusted for Symmetry.

Figure 2 Relevance of factors limiting early diagnosis of COPD according to expert panel.

Note: First, second, third, and fourth refer to the rank order of the answers.
Abbreviation: GP, general practitioner.

Figure 3 Level of confidence in different approaches used in the early management of COPD to reduce the functional decline.

Note: Each pairwise comparison was significant (P<0.001).

Abbreviations: ICS, inhaled corticosteroid; LABA, long-acting beta-agonist; LAMA, long-acting muscarinic antagonist.

Figure 3 Level of confidence in different approaches used in the early management of COPD to reduce the functional decline.Note: Each pairwise comparison was significant (P<0.001).Abbreviations: ICS, inhaled corticosteroid; LABA, long-acting beta-agonist; LAMA, long-acting muscarinic antagonist.

Figure 4 Level of consensus on different treatments in patients younger and older with moderate obstruction (mean ± 95% CI).

Abbreviations: ICS, inhaled corticosteroid; LABA, long-acting beta-agonist; LAMA, long-acting muscarinic antagonist.

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

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