COPD: Coming to a Consensus

Approximately 24 million Americans have airway obstruction that is suggestive of COPD. With close to 125,000 annual deaths attributed to the disease, COPD now ranks as the third leading cause of death in the United States. Despite the disease’s wide scope, about 50% of patients are undiagnosed, largely because it’s underrecognized by the public. COPD progresses slowly, with early disease presenting with mild symptoms that patients learn to live with. Many COPD sufferers view their symptoms as a part of aging. Only few link them to smoking, the primary cause of the disease. Clinicians Play a Vital Role in Diagnosing COPD Despite recommendations from national guidelines, many clinicians throughout the U.S. do not utilize spirometry, an important tool in diagnosing COPD, because they feel it’s too time-consuming or expensive. This can lead to under-diagnosis, a problem commonly seen in the outpatient setting. Further complicating the issue is that many patients with COPD don’t receive a diagnosis until they are hospitalized from exacerbations that are usually triggered by infections. About 750,000 patients with COPD require hospitalizations each year. These patients tend to have poorer long-term outcomes than those diagnosed and treated effectively in the outpatient setting. Prevention of hospitalizations due to exacerbations through early diagnosis and treatment, smoking cessation, and increased awareness of COPD among patients and providers is important. 7 Key Recommendations for COPD There are several guidelines for COPD, including those from the American Thoracic Society, European Respiratory Society, American College of Physicians, and American College of Chest Physicians. In the August 2, 2011 Annals of Internal Medicine, my colleagues and I published a consensus that brings together...