Submitted by Zach Baldwin on

Please complete the Improving Patient Outcomes for COPD course and then comment on this discussion topic to share your experiences, takeaways, and outstanding questions. 

Consider responding to one of the questions below:

  1. What has been your experience with screening, treating and managing chronic obstructive pulmonary disease (COPD) in a primary care setting? Share both positive and negative experiences. 
  2. What questions do you still have about treating and monitoring COPD in primary care?
  3. What do you want to know from other clinicians who screen for and treat COPD?

Comments

Sanjay Sethi replied on

Have you wondered what to do with patients who appear to have COPD because of smoking history and symptoms but do not meet the criteria of airflow obstruction by spirometry? This is may be of particular concern if they have emphysema or airway wall thickening on a CT scan of the chest.

Though the definitive diagnosis of COPD requires demonstration of airflow obstruction by spirometry, analysis of data from the COPD Gene study suggests that we should consider categories of ‘probable’ and ‘possible’ COPD. All these patients have adequate tobacco smoke exposure (>10 pack-yrs) to be at risk of COPD. The ‘probable’ patients have symptoms and radiological changes, while the ‘possible’ ones have only one of those diagnostic features.

Though this concept has yet not been adopted by international recommendations, I have started to apply it in my ‘borderline’ COPD patients or in those where I had diagnostic confusion between asthma and COPD, in order to guide my therapeutic approach. I may give these patients a trial of a long-acting bronchodilator to see if they note improvement in symptoms. I am interested in hearing about other’s experience with similar patients.

Sanjay Sethi replied on

Cynthia Bergin replied on

What has been your experience with screening, treating and managing chronic obstructive pulmonary disease (COPD) in a primary care setting? Share both positive and negative experiences.

 

I have been a nurse for over 30 years. My experience with Managing Patients with COPD has been their adherence to the treatment protocol.   I have worked closely with Pulmonary Rehab over my years of Nursing and really do think this is such a vital role in Pulmonary Wellness.   It really does not seem to be stressed as necessary - education and awareness on the disease process  is such a huge piece for maintenance and continuity of care and maintenance for those with this diagnosis.   Individuals with COPD need continuous support to prevent depression.  These patients need to be encouraged to engage in Pulmonary Rehab for not only the medical benefits but also for the emotional support. 

Cynthia Bergin replied on

Veronica Portillo replied on

  1. What has been your experience with screening, treating and managing chronic obstructive pulmonary disease (COPD) in a primary care setting? Share both positive and negative experiences. 

My experience with managing COPD has been challenging at times and so very rewarding at others. I have been part of helping patients quit smoking and actually providing continuous support for patients before, while and after quitting. I feel that this is one of my success stories, a patient that had been smoking for the past 20 something years was able to stop smoking while I was part of her care. This wonderfully resulted in positive COPD management, by allowing patient to go without having to be admitted due to an exacerbation of her COPD for an entire year. After this training, pulmonary rehab has been on top of mind to support my patients. This was not something that I would think of doing and will from now on recommend as an important part of managing COPD. 

Veronica Portillo replied on