Management of the COPD Patient with Comorbidities: An Experts Recommendation Document
Open Access
- 1 May 2020
- journal article
- research article
- Published by Taylor & Francis Ltd in International Journal of Chronic Obstructive Pulmonary Disease
- Vol. ume 15, 1015-1037
- https://doi.org/10.2147/copd.s242009
Abstract
Background: Chronic obstructive pulmonary disease (COPD) is associated with multiple comorbidities, which impact negatively on patients and are often underdiagnosed, thus lacking a proper management due to the absence of clear guidelines. Purpose: To elaborate expert recommendations aimed to help healthcare professionals to provide the right care for treating COPD patients with comorbidities. Methods: A modified RAND-UCLA appropriateness method consisting of nominal groups to draw up consensus recommendations (6 Spanish experts) and 2-Delphi rounds to validate them (23 Spanish experts) was performed. Results: A panel of Spanish internal medicine experts reached consensus on 73 recommendations and 81 conclusions on the clinical consequences of the presence of comorbidities. In general, the experts reached consensus on the issues raised with regard to cardiovascular comorbidity and metabolic disorders. Consensus was reached on the use of selective serotonin reuptake inhibitors in cases of depression and the usefulness of referring patients with anxiety to respiratory rehabilitation programmes. The results also showed consensus on the usefulness of investigating the quality of sleep, the treatment of pain with opioids and the evaluation of osteoporosis by lateral chest radiography. Conclusion: This study provides conclusions and recommendations that are intended to improve the management of the complexity of patients with COPD and important comorbidities, usually excluded from clinical trials.This publication has 305 references indexed in Scilit:
- The Effect of Complex Interventions on Depression and Anxiety in Chronic Obstructive Pulmonary Disease: Systematic Review and Meta-AnalysisPLOS ONE, 2013
- Anemia and performance status as prognostic markers in acute hypercapnic respiratory failure due to chronic obstructive pulmonary diseaseInternational Journal of Chronic Obstructive Pulmonary Disease, 2013
- Pulmonary embolism and 3-month outcomes in 4036 patients with venous thromboembolism and chronic obstructive pulmonary disease: data from the RIETE registryRespiratory Research, 2013
- Association of Gastroesophageal Reflux Disease Symptoms with Stable Chronic Obstructive Pulmonary DiseaseLung, 2012
- Effects of medical and psychological treatment of depression in patients with COPD – A reviewRespiratory Medicine, 2011
- Prospective evaluation of the relationship between acute exacerbations of COPD and gastroesophageal reflux disease diagnosed by questionnaireRespiratory Medicine, 2011
- Acute Exacerbations of Chronic Obstructive Pulmonary Disease and the Effect of Existing Psychiatric Comorbidity on Subsequent MortalityPsychosomatics, 2011
- β-Blockers May Reduce Mortality and Risk of Exacerbations in Patients With Chronic Obstructive Pulmonary DiseaseArchives of Internal Medicine, 2010
- Depression and Health-Related Quality of Life in Chronic Obstructive Pulmonary DiseaseAmerican Journal Of Medicine, 2009
- Reduction of Morbidity and Mortality by Statins, Angiotensin-Converting Enzyme Inhibitors, and Angiotensin Receptor Blockers in Patients With Chronic Obstructive Pulmonary DiseaseJournal of the American College of Cardiology, 2006