Diagnosis and management of stable chronic obstructive pulmonary disease: a clinical practice guideline from the American College of Physicians - PubMed (original) (raw)
Practice Guideline
. 2007 Nov 6;147(9):633-8.
Affiliations
- PMID: 17975186
Practice Guideline
Diagnosis and management of stable chronic obstructive pulmonary disease: a clinical practice guideline from the American College of Physicians
Amir Qaseem et al. Ann Intern Med. 2007.
Abstract
RECOMMENDATION 1: In patients with respiratory symptoms, particularly dyspnea, spirometry should be performed to diagnose airflow obstruction. Spirometry should not be used to screen for airflow obstruction in asymptomatic individuals. (Grade: strong recommendation, moderate-quality evidence.) RECOMMENDATION 2: Treatment for stable chronic obstructive pulmonary disease (COPD) should be reserved for patients who have respiratory symptoms and FEV1 less than 60% predicted, as documented by spirometry. (Grade: strong recommendation, moderate-quality evidence.) RECOMMENDATION 3: Clinicians should prescribe 1 of the following maintenance monotherapies for symptomatic patients with COPD and FEV1 less than 60% predicted: long-acting inhaled beta-agonists, long-acting inhaled anticholinergics, or inhaled corticosteroids. (Grade: strong recommendation, high-quality evidence.) RECOMMENDATION 4: Clinicians may consider combination inhaled therapies for symptomatic patients with COPD and FEV1 less than 60% predicted. (Grade: weak recommendation, moderate-quality evidence.) RECOMMENDATION 5: Clinicians should prescribe oxygen therapy in patients with COPD and resting hypoxemia (Pao2 < or =55 mm Hg). (Grade: strong recommendation, moderate-quality evidence.) RECOMMENDATION 6: Clinicians should consider prescribing pulmonary rehabilitation in symptomatic individuals with COPD who have an FEV1 less than 50% predicted. (Grade: weak recommendation, moderate-quality evidence.).
Comment in
- New guideline for COPD: inhaled treatments similarly effective.
[No authors listed] [No authors listed] J Fam Pract. 2008 Jan;57(1):10. J Fam Pract. 2008. PMID: 18175405 No abstract available. - Will recommendations against spirometry make chronic obstructive pulmonary disease harder to treat?
Petty TL, Mannino DM. Petty TL, et al. Ann Intern Med. 2008 Oct 7;149(7):512-3; author reply 513. doi: 10.7326/0003-4819-149-7-200810070-00015. Ann Intern Med. 2008. PMID: 18838733 No abstract available.
Summary for patients in
- Summaries for patients. Diagnosis and management of chronic obstructive pulmonary disease: a clinical practice guideline from the American College of Physicians.
[No authors listed] [No authors listed] Ann Intern Med. 2007 Nov 6;147(9):I41. doi: 10.7326/0003-4819-147-9-200711060-00002. Ann Intern Med. 2007. PMID: 17975179 No abstract available.
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