Overview: Exacerbations of Chronic Obstructive Pulmonary Disease
The full newsletter Exacerbations of Chronic Obstructive Pulmonary Disease, prescribing information and CME self-assessment are free for both AMA members and non-members.
COPD is a leading cause of morbidity and mortality worldwide, and results in an economic and social burden that is both substantial and increasing. The prevalence and morbidity data greatly underestimate the total burden of COPD because the disease is usually not diagnosed until it is clinically apparent and moderately advanced. In people aged 25–75 yrs in the U.S., the estimated prevalence of mild COPD is 6.9% and moderate COPD is estimated at 6.6%. COPD is the fourth-leading cause of death in the U.S. and Europe, and COPD mortality in females has more than doubled over the last 20 yrs.
Exacerbations of COPD were once regarded as trivial events, dismissed as ‘chest colds’ of little consequence to the natural history of this disorder. This was based on studies from the 1950s and 60s that did not find a relationship between decline of FEV1 over time and frequency of exacerbations. In the last two decades, a resurgence of research interest has diametrically shifted our perspective about their importance. Disease-specific quality of life or health status is significantly worsened at exacerbation, and their frequency is associated with the decline in this health status over time.
A multi-pronged approach, with individualization based on guidelines and clinical judgment, is necessary to treat exacerbations of COPD. Symptomatic treatment offered includes the introduction or intensification of bronchodilators, use of mucolytics, expectorants and cough suppressants, and attention to hydration and nutrition. Though controversial in the past, antibiotics are now recommended for use in all exacerbations with the exception of mild, limited symptom episodes. Advances have also been made to guide a more rational choice of antibiotics.
In "Exacerbations of Chronic Obstructive Pulmonary Disease" physicians will learn to:
- Apply evidence-based approaches to the prevention and treatment of exacerbations of COPD
- Compare his/her current approach to treatment at the national level with professional guideline recommendations.
The full newsletter will also provide insights into the use of antibiotics and corticosteroids in this disease entity.
View the full newsletter Exacerbations of Chronic Obstructive Pulmonary Disease, and learn how to receive CME credit. Newsletters are available to all physicians, not just AMA members.