Diagnosis and management of stable chronic obstructive pulmonary disease: a clinical practice guideline from the American College of Physicians.

Authors

• Amir Qaseem
• Vincenza Snow
• Paul Shekelle
• Katherine Sherif
• Timothy J Wilt
• Steven Weinberger
• Douglas K Owens

Publication/Presentation Date

11-6-2007

Abstract

RECOMMENDATION 1: In patients with respiratory symptoms, particularly dyspnea, spirometry should be performed to diagnose airflow obstruction. Spirometry should not be used to screen for airflow obstruction in asymptomatic individuals. (Grade: strong recommendation, moderate-quality evidence.) RECOMMENDATION 2: Treatment for stable chronic obstructive pulmonary disease (COPD) should be reserved for patients who have respiratory symptoms and FEV1 less than 60% predicted, as documented by spirometry. (Grade: strong recommendation, moderate-quality evidence.) RECOMMENDATION 3: Clinicians should prescribe 1 of the following maintenance monotherapies for symptomatic patients with COPD and FEV1 less than 60% predicted: long-acting inhaled beta-agonists, long-acting inhaled anticholinergics, or inhaled corticosteroids. (Grade: strong recommendation, high-quality evidence.) RECOMMENDATION 4: Clinicians may consider combination inhaled therapies for symptomatic patients with COPD and FEV1 less than 60% predicted. (Grade: weak recommendation, moderate-quality evidence.) RECOMMENDATION 5: Clinicians should prescribe oxygen therapy in patients with COPD and resting hypoxemia (Pao2 < or =55 mm Hg). (Grade: strong recommendation, moderate-quality evidence.) RECOMMENDATION 6: Clinicians should consider prescribing pulmonary rehabilitation in symptomatic individuals with COPD who have an FEV1 less than 50% predicted. (Grade: weak recommendation, moderate-quality evidence.).

Volume

147

Issue

9

First Page

633

Last Page

638

ISSN

1539-3704

Published In/Presented At

Qaseem, A., Snow, V., Shekelle, P., Sherif, K., Wilt, T. J., Weinberger, S., Owens, D. K., & Clinical Efficacy Assessment Subcommittee of the American College of Physicians (2007). Diagnosis and management of stable chronic obstructive pulmonary disease: a clinical practice guideline from the American College of Physicians. Annals of internal medicine, 147(9), 633–638.

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

17975186

Department(s)

Administration and Leadership

Document Type

Article