scholarly journals Integrated management strategies for chronic obstructive pulmonary disease

2010 ◽  
pp. 181
Author(s):  
Sandra Adams
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Integrated Management ◽  
Management Strategies ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease

scholarly journals Canadian Thoracic Society Recommendations for Management of Chronic Obstructive Pulmonary Disease – 2003

2003 ◽  
Vol 10 (suppl a) ◽  
pp. 11A-33A ◽  
Author(s):  
Denis E O’donnell ◽  
Shawn Aaron ◽  
Jean Bourbeau ◽  
Paul Hernandez ◽  
Darcy D Marciniuk ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Early Diagnosis ◽  
Pulmonary Disease ◽  
Management Strategies ◽  
Management Plan ◽  
Morbidity And Mortality ◽  
Chronic Obstructive ◽  
Activity Levels ◽  
Obstructive Pulmonary Disease ◽  
Comprehensive Management

Chronic obstructive pulmonary disease (COPD) is a common cause of disability and death in Canada. Moreover, morbidity and mortality from COPD continue to rise and the economic burden is enormous. The main goal of the Canadian Thoracic Society (CTS) Evidence-Based Guidelines is to optimize early diagnosis, prevention and management of COPD in Canada. Targeted spirometry is strongly recommended to expedite early diagnosis in smokers and exsmokers who develop respiratory symptoms, and who are at risk for COPD. Smoking cessation remains the single most effective intervention to reduce the risk of COPD and to slow its progression. Education, especially self-management plans, are key interventions in COPD. Therapy should be escalated in accordance with the increasing severity of symptoms and disability. Long acting anticholinergics and beta2-agonist inhalers should be prescribed for patients who remain symptomatic despite short-acting bronchodilator therapy. Inhaled steroids should not be used as first line therapy in COPD, but have a role in preventing exacerbations in patients with more advanced disease who suffer recurrent exacerbations. Management strategies consisting of combined modern pharmacotherapy and nonpharmacotherapeutic interventions (eg, pulmonary rehabilitation/exercise training) can effectively improve symptoms, activity levels, and quality of life, even in patients with severe COPD. Acute exacerbations of COPD cause significant morbidity and mortality and should be treated promptly with bronchodilators and a short course of oral steroids; antibiotics should be prescribed for purulent exacerbations. Patients with advanced COPD and respiratory failure require a comprehensive management plan that incorporates structured end-of-life care.

scholarly journals Nutritional modulation as part of the integrated management of chronic obstructive pulmonary disease

2003 ◽  
Vol 62 (4) ◽  
pp. 783-791 ◽  
Author(s):  
Annemie Schols
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Weight Loss ◽  
Dietary Intake ◽  
Pulmonary Disease ◽  
Systemic Inflammation ◽  
Integrated Management ◽  
Fat Free Mass ◽  
Functional Improvement ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease

Weight loss is a frequent complication in patients with chronic obstructive pulmonary disease (COPD) and is a determining factor for functional capacity, health status and mortality. Weight loss in COPD is a consequence of an inbalance between increased energy requirements and dietary intake. Both metabolic and mechanical inefficiency may contribute to elevated energy expenditure during physical activity, while systemic inflammation has been associated with hypermetabolism at rest. Disease-specific symptoms and systemic inflammation may impair appetite and dietary intake. Altered intermediary metabolism may cause disproportionate wasting of fat-free mass in some patients. A combination of nutritional support and exercise as an anabolic stimulus appears to be the best approach to obtaining marked functional improvement. Patients responding to this treatment even demonstrated a decreased mortality. The effectiveness of anti-catabolic modulation requires further investigation.

scholarly journals State of the Art Compendium: Canadian Thoracic Society Recommendations for Management of Chronic Obstructive Pulmonary Disease

2004 ◽  
Vol 11 (suppl b) ◽  
pp. 7B-59B ◽  
Author(s):  
Denis E O’Donnell ◽  
Shawn Aaron ◽  
Jean Bourbeau ◽  
Paul Hernandez ◽  
Darcy Marciniuk ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Early Diagnosis ◽  
Pulmonary Disease ◽  
Management Strategies ◽  
Management Plan ◽  
Morbidity And Mortality ◽  
Chronic Obstructive ◽  
Activity Levels ◽  
Obstructive Pulmonary Disease ◽  
Comprehensive Management

Chronic obstructive pulmonary disease (COPD) is a common cause of disability and death in Canada. Moreover, morbidity and mortality from COPD continue to rise, and the economic burden is enormous. The main goal of the Canadian Thoracic Society’s evidence-based guidelines is to optimize early diagnosis, prevention and management of COPD in Canada. The main message of the guidelines is that COPD is a preventable and treatable disease. Targeted spirometry is strongly recommended to expedite early diagnosis in smokers and former smokers who develop respiratory symptoms, and who are at risk for COPD. Smoking cessation remains the single most effective intervention to reduce the risk of COPD and to slow its progression. Education, especially self-management plans, are key interventions in COPD. Therapy should be escalated on an individual basis in accordance with the increasing severity of symptoms and disability. Long-acting anticholinergics and beta-2-agonist inhalers should be prescribed for patients who remain symptomatic despite short-acting bronchodilator therapy. Inhaled steroids should not be used as first line therapy in COPD, but have a role in preventing exacerbations in patients with more advanced disease who suffer recurrent exacerbations. Acute exacerbations of COPD cause significant morbidity and mortality and should be treated promptly with bronchodilators and a short course of oral steroids; antibiotics should be prescribed for purulent exacerbations. Patients with advanced COPD and respiratory failure require a comprehensive management plan that incorporates structured end-of-life care. Management strategies, consisting of combined modern pharmacotherapy and nonpharmacotherapeutic interventions (eg, pulmonary rehabilitation and exercise training) can effectively improve symptoms, activity levels and quality of life, even in patients with severe COPD.

scholarly journals Maintenance of non-pharmacological strategies 6 months after patients with chronic obstructive pulmonary disease (COPD) attend a breathlessness service: a qualitative study

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e050149
Author(s):  
Tim Luckett ◽  
Mary Roberts ◽  
Vinita Swami ◽  
Tracy Smith ◽  
Jin-Gun Cho ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Psychological Intervention ◽  
Management Strategies ◽  
Self Management ◽  
Integrative Approach ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Chaos Narrative ◽  
Severe Copd

ObjectivesThis study aimed to explore the degree to which non-pharmacological strategies for chronic breathlessness are sustained 6 months after completing a breathlessness service in patients with chronic obstructive pulmonary disease (COPD), and patient perceptions regarding the need for ongoing support.DesignA qualitative approach was taken using semistructured telephone interviews. Thematic analysis used an integrative approach.SettingThe Westmead Breathlessness Service (WBS) trains patients with COPD to self-manage chronic breathlessness over an 8-week programme with multidisciplinary input and home visits.ParticipantsPatients with moderate to very severe COPD who had completed the WBS programme 6 months earlier.ResultsThirty-two participants were interviewed. One or more breathlessness self-management strategies were sustained by most participants, including breathing techniques (n=22; 69%), the hand-held fan (n=17; 53%), planning/pacing and exercise (n=14 for each; 44%) and strategic use of a four-wheeled walker (n=8; 25%). However, almost a third of participants appeared to be struggling psychologically, including some who had refused psychological intervention. A ‘chaos narrative’ appeared to be prevalent, and many participants had poor recall of the programme.ConclusionsSelf-management strategies taught by breathlessness services to patients with moderate to very severe COPD have potential to be sustained 6 months later. However, psychological coping may be more challenging to maintain. Research is needed on ways to improve resilience to set-backs and uptake of psychological interventions, as well as to understand and address the implications of poor recall for self-management.Trial registration numberACTRN12617000499381

scholarly journals Usefulness and Relevance of an eHealth Tool in Supporting the Self-Management of Chronic Obstructive Pulmonary Disease: Explorative Qualitative Study of a Cocreative Process (Preprint)

2018 ◽  
Author(s):  
Malin Tistad ◽  
Sara Lundell ◽  
Maria Wiklund ◽  
André Nyberg ◽  
Åsa Holmner ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Primary Care ◽  
Health Care ◽  
Pulmonary Disease ◽  
Health Care Professionals ◽  
Qualitative Content Analysis ◽  
Management Strategies ◽  
Self Management ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease

BACKGROUND New strategies are urgently needed to support self-management for people with chronic obstructive pulmonary disease (COPD) in primary care. The use of electronic health (eHealth) solutions is promising. However, there is a lack of knowledge about how such eHealth tools should be designed in order to be perceived as relevant and useful and meet the needs and expectations of the health professionals as well as people with COPD and their relatives. OBJECTIVE The objective of this study was to explore the aspects of an eHealth tool design and content that make it relevant and useful for supporting COPD-related self-management strategies from the perspective of health care professionals, people with COPD and their relatives, and external researchers. METHODS Data were collected during the development of an eHealth tool. A cocreation process was carried out with participants from two primary care units in northern Sweden and external researchers. Individual interviews were performed with health care professionals (n=13) as well as people with COPD (n=6) and their relatives (n=2), and focus group discussions (n=9) were held with all groups of participants. Data were analyzed using qualitative content analysis. RESULTS The overarching theme, reinforcing existing support structures, reflects participant views that the eHealth tool needs to be directly applicable and create a sense of commitment in users. Moreover, participants felt that the tool needs to fit with existing routines and contexts and preferably should not challenge existing hierarchies between health care professionals and people with COPD. Important content for health care professionals and people with COPD included knowledge about self-management strategies. Videos were regarded as the most effective method for communicating such knowledge. CONCLUSIONS The cocreation in the development process enables participant perspectives and priorities to be built into the eHealth tool. This is assumed to contribute to a tool that is useful and relevant and, therefore, adopted into clinical practice and everyday life. Findings from this study can inform the development of eHealth tools for people with COPD in other contexts, as well as the development of eHealth tools for self-management support of other chronic diseases.

Sign in / Sign up

Export Citation Format

Share Document