2023 Canadian Thoracic Society Guideline on Pharmacotherapy in Patients With Stable COPD
Chest. 2023 Sep 6:S0012-3692(23)05275-3. doi: 10.1016/j.chest.2023.08.014. Online ahead of print.ABSTRACTChronic obstructive pulmonary disease patient care must include confirming a diagnosis with postbronchodilator spirometry. Because of the clinical heterogeneity and the reality that airflow obstruction assessed by spirometry only partially reflects disease severity, a thorough clinical evaluation of the patient should include assessment of symptom burden and risk of exacerbations that permits the implementation of evidence-informed pharmacologic and nonpharmacologic interventions. This guideline provides recommendations from a comprehensive systematic review with a meta-analysis and expert-informed clinical remarks to optimize maintenance pharmacologic therapy for individuals with stable COPD, and a revised and practical treatment pathway based on new evidence since the 2019 update of the Canadian Thoracic Society (CTS) Guideline. The key clinical questions were developed using the Patients/Population (P), Intervention(s) (I), Comparison/Comparator (C), and Outcome (O) model for three questions that focuses on the outcomes of symptoms (dyspnea)/health status, acute exacerbations, and mortality. The evidence from this systematic review and meta-analysis leads to the recommendation that all symptomatic patients with spirometry-confirmed COPD should receive long-acting bronchodilator maintenance therapy. Those with moderate to severe dyspnea (modified Medical Research Council...
Source: Chest - Category: Respiratory Medicine Authors: Jean Bourbeau Mohit Bhutani Paul Hernandez Shawn D Aaron Marie-France Beauchesne Sophie B Kermelly Anthony D'Urzo Avtar Lal Fran çois Maltais Jeffrey D Marciniuk Sunita Mulpuru Erika Penz Don D Sin Anne Van Dam Joshua Wald Brandie L Walker Darcy D Marcin Source Type: research
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