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Chronic obstructive pulmonary disease - diagnosis and management of stable disease; a personalized approach to care, using the treatable traits concept based on clinical phenotypes. Position paper of the Czech Pneumological and Phthisiological Society
- Source :
- Biomedical Papers, Vol 164, Iss 4, Pp 325-356 (2020)
- Publication Year :
- 2020
-
Abstract
- This position paper has been drafted by experts from the Czech national board of diseases with bronchial obstruction, of the Czech Pneumological and Phthisiological Society. The statements and recommendations are based on both the results of randomized controlled trials and data from cross-sectional and prospective real-life studies to ensure they are as close as possible to the context of daily clinical practice and the current health care system of the Czech Republic. Chronic Obstructive Pulmonary Disease (COPD) is a preventable and treatable heterogeneous syndrome with a number of pulmonary and extrapulmonary clinical features and concomitant chronic diseases. The disease is associated with significant mortality, morbidity and reduced quality of life. The main characteristics include persistent respiratory symptoms and only partially reversible airflow obstruction developing due to an abnormal inflammatory response of the lungs to noxious particles and gases. Oxidative stress, protease-antiprotease imbalance and increased numbers of pro-inflammatory cells (mainly neutrophils) are the main drivers of primarily non-infectious inflammation in COPD. Besides smoking, household air pollution, occupational exposure, low birth weight, frequent respiratory infections during childhood and also genetic factors are important risk factors of COPD development. Progressive airflow limitation and airway remodelling leads to air trapping, static and dynamic hyperinflation, gas exchange abnormalities and decreased exercise capacity. Various features of the disease are expressed unequally in individual patients, resulting in various types of disease presentation, emerging as the "clinical phenotypes" (for specific clinical characteristics) and "treatable traits" (for treatable characteristics) concept. The estimated prevalence of COPD in Czechia is around 6.7% with 3,200-3,500 deaths reported annually. The elementary requirements for diagnosis of COPD are spirometric confirmation of post-bronchodilator airflow obstruction (post-BD FEV1/VCmax
- Subjects :
- Adult
Male
medicine.medical_specialty
Chronic bronchitis
Palliative care
Exacerbation
medicine.medical_treatment
lcsh:Medicine
Disease
030204 cardiovascular system & hematology
General Biochemistry, Genetics and Molecular Biology
Pulmonary function testing
03 medical and health sciences
Pulmonary Disease, Chronic Obstructive
0302 clinical medicine
Patient-Centered Care
medicine
Pulmonary Medicine
Humans
Pulmonary rehabilitation
Prospective Studies
Intensive care medicine
clinical phenotypes
Asthma
Aged
Czech Republic
Aged, 80 and over
COPD
business.industry
lcsh:R
copd
personalized medicine
treatable traits
Middle Aged
medicine.disease
respiratory tract diseases
bronchodilators
3. Good health
Bronchodilator Agents
Cross-Sectional Studies
Phenotype
030220 oncology & carcinogenesis
individualized care
Chronic Disease
Practice Guidelines as Topic
Female
business
position paper
Subjects
Details
- ISSN :
- 18047521
- Volume :
- 164
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia
- Accession number :
- edsair.doi.dedup.....df96e808159d0b54f92facaa808761a7