Primary care providers have a key role in the diagnosis and management of COPD. Consider diagnosis of COPD in adults with shortness of breath, with or without symptoms of cough and sputum production. Risk factors other than cigarette smoking history are important. Ten to 20 percent of cases may be due to environmental and occupational exposures. Pulmonary function testing is useful for determining the severity of COPD and distinguishing from asthma. Therapies are effective. Proactive treatment can improve the quality of life for patients with COPD.
WHY COPD? WHY NOW?
- While other major causes of death have been decreasing, COPD mortality has continued to rise.
- COPD is the 4th leading cause of death.
- 12 million Americans are diagnosed with COPD; research shows that many do not get optimal treatment.
- An additional 12 million Americans may have COPD and remain undiagnosed.
- Recent advances in treatment for COPD offer real opportunities to improve your patient's quality and length of life.
RISK FACTORS
Look for COPD in patients who are over 40 and have:
- Persistent or progressive dyspnea
- Chronic cough or sputum production
- Decline in level of activity
COPD is more likely if there is a history of smoking.
Genetic factors and environmental or occupational exposures may also play a role: as many as 1 out of 6 Americans with COPD has never smoked.
DIAGNOSIS: PULMONARY FUNCTION TESTING
Perform or refer for a lung function test—spirometry— to determine the severity. Spirometry with bronchodilator testing may distinguish COPD from asthma. A criterion for diagnosis of COPD is a postbronchodilator FEV1/FVC<0.7.
TREATMENT
Aggressive management of COPD can make a difference for the patient.
Advances in therapies have been shown to improve survival or quality of life for COPD patients.
COPD patients should receive professional assistance for smoking cessation.
This information and more can be found at www.nhlbi.nih.gov.