gms | German Medical Science

Background: Chronic obstructive pulmonary disease (COPD) is a common, preventable and treatable chronic disease with increasing prevalence. The disease is a major cause of morbidity and mortality throughout the world. In the past years many studies have been reported in the literature including topics of epidemiology, co-morbidity, pathogenesis, pulmonary function testing, pharmacotherapy and non-pharmacological treatment of COPD. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) issued its first report, Global Strategy for the Diagnosis, Management, and Prevention of COPD, in 2001. Based on literature and updated GOLD a short pocket guide COPD has been developed for physicians at the University hospital Jena in 2016 which was now updated. The updated pocket guide based on the GOLD report 2017 taking in account specifics in Germany.

Materials and methods: Creating an updated short pocket guide COPD for the University hospital Jena. The document is based on recent recommendations of Global Strategy for the Diagnosis, Management and Prevention of COPD (last updated 2019).

Results: The updated pocket guide COPD is a short document of 5 pages with some tables. It presents background information on COPD, information on diagnosis, assessment and therapeutic options. The goals of COPD assessment are to determine the severity of the disease, its impact on patient’s health status, and the risk of future events in order to guide therapy. Validated questionnaires such as the COPD assessment test (CAT) are recommended for a comprehensive assessment of symptoms. The spirometric classification is divided into four grades (GOLD 1, mild; GOLD 2, moderate; GOLD 3, sever; and GOLD 4, very severe). Combined COPD assessment includes symptoms, breathlessness, spirometric classification and risk of exacerbations when classifying the disease severity from A to D. Each treatment regimen needs to be patient-specific based on the classifying of the disease severity from A to D. The classes of medications commonly used in treating COPD are listed. Several pharmacological options are available, including bronchodilators (e.g. β2-adrenoreceptor agonists, anticholinergics and theophylline), inhaled corticosteroids (ICS) and phosphodiesterase-4 (PDE4) inhibitors according to disease severity classification. Pharmacologic therapy for COPD is used to reduce symptoms, to reduce the frequency and severity of exacerbations, and to improve exercise tolerance and health status.

Non-pharmacological management according to the individualized assessment is also included as well as the management of exacerbations.

Conclusion: The updated pocket guide for the University Hospital Jena provides a short current overview of management of COPD based on the updated Global Strategy for Diagnosis, Management and Prevention of Chronic Obstructive Pulmonary Disease for physicians. The updated pocket guide was implemented in the University Hospital Jena as a rational basis for diagnostic and treatment of COPD. These recommendations will be regularly re-evaluated and up-dated whenever new data become available.