Integrated Chronic Obstructive Pulmonary Disease Management in Primary Care
Niels H. Chavannes
Increased attention has recently been paid to disease management programs in the primary care of chronic obstructive pulmonary disease (COPD). Key elements of these programs are reactivation, lifestyle change, and exacerbation management. It is important that the patient is actively involved in the treatment plan. After diagnosis of COPD by repeated spirometry, a tailored disease management program should be designed in collaboration with the patient. Individual points of attention could be encouraging smoking cessation, improving inhaler technique, or improving exercise tolerance. Central to disease management of COPD is multidisciplinary implementation of an exacerbation rapid action plan. Research has shown that self-management of exacerbations reduces their duration, which presents a further argument for the active involvement of the patient in developing their treatment plan. A region-wide implementation plan based on the At present, approximately 2.8% of the total practice population is participating in the program. Almost all participants in the 6-month training program have reported perceptible and measurable improvements in exercise tolerance, and a strong collaboration has developed between primary care providers, patients, and secondary care. DOI: 10.2165/0115677-200816050-00007
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