Combination Bronchodilator Therapy in COPD Management
Combination Bronchodilator Therapy in COPD Management
2011 saw a substantial revision of the Global initiative for chronic Obstructive Lung Disease (GOLD) guidelines for diagnosis, management, and prevention of COPD, which has recently been updated. Recommendations for treatment are no longer based primarily on categorization ("staging") by spirometric assessment, but on categorization by existing symptoms (using validated modified Medical Research Council and COPD Assessment Test questionnaires) and risk (based on severity of airflow limitation and history of exacerbations). This approach acknowledges the importance of consideration of both short- and long-term outcomes when making treatment decisions (Figure 1).
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Figure 1.
Model of symptom/risk of evaluation of COPD [9]. From the Global Strategy for Diagnosis, Management and Prevention of COPD 2013, Global initiative for chronic Obstructive Lung Disease (GOLD), http://www.goldcopd.org. COPD = chronic obstructive lung disease; GOLD = Global initiative for chronic Obstructive Lung Disease; mMRC = modified Medical Research Council; CAT = COPD Assessment Test.
Evolving COPD Guidelines
2011 saw a substantial revision of the Global initiative for chronic Obstructive Lung Disease (GOLD) guidelines for diagnosis, management, and prevention of COPD, which has recently been updated. Recommendations for treatment are no longer based primarily on categorization ("staging") by spirometric assessment, but on categorization by existing symptoms (using validated modified Medical Research Council and COPD Assessment Test questionnaires) and risk (based on severity of airflow limitation and history of exacerbations). This approach acknowledges the importance of consideration of both short- and long-term outcomes when making treatment decisions (Figure 1).
(Enlarge Image)
Figure 1.
Model of symptom/risk of evaluation of COPD [9]. From the Global Strategy for Diagnosis, Management and Prevention of COPD 2013, Global initiative for chronic Obstructive Lung Disease (GOLD), http://www.goldcopd.org. COPD = chronic obstructive lung disease; GOLD = Global initiative for chronic Obstructive Lung Disease; mMRC = modified Medical Research Council; CAT = COPD Assessment Test.