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Authors & contributors
Contents
Foreword
The COPD-X guidelines
Levels of evidence
Summary of the COPD-X guidelines
Confirm
diagnosis &
assess severity
Optimise function
Prevent deterioration
Develop support network
Manage eXacerbations
Appendices
References
References reviewed but not cited
Other issues
>
Refs 1-50
>
Aetiology
>
Summary
>
Contents
Contents
Authors and contributors
Contents
Foreword
The COPD guidelines
Levels of evidence
Summary of the COPDX guidelines
C: Confirm diagnosis and assess severity
C1.
Aetiology and natural history
C2.
Diagnosis
C2.
1
History
C2.
2
Physical examination
C2.
3
Spirometry
C2.
4
Flow volume tests
C3.
Assessing the severity of COPD
C4.
Assessing acute response to bronchodilators
C4.
1
Confirm or exclude asthma
C5:
Specialist referral
C5.
1
Complex lung function tests
C5.
2
Exercise testing
C5.
3
Sleep studies
C5.
4
Chest x-rays
C5.
5
High resolution computed tomography
C5.
6
Ventilation and perfusion scans
C5.
7
Transcutaneous oxygen saturation
C5.
8
Arterial blood gas measurement
C5.
9
Sputum examination
C5.
10
Haematology and biochemistry
C5.
11
Electrocardiography and echocardiography
C5.
12
Trials of Therapy
O: Optimise function
O1.
Inhaled bronchodilators
01.
1
Short-acting bronchodilators
01.
1.1
Short-acting beta-agonists
01.
1.2
Short-acting anticholinergics
01.
1.3
Short-acting bronchodilator combinations
01.
2
Long-acting bronchodilators
01.
2.1
Long-acting beta-agonists
01.
2.2
Long-acting anticholinergics
01.
2.3
Long-acting bronchodilator combinations
01.
3
Assessment of response and continuation of bronchodilator therapy
02.
Oral bronchodilators
02.
1
Methylxanthines
02.
2
Phosphodiesterase type-4 inhibitors
O3.
Glucocorticoids
O3.
1
Oral glucocorticoids
O3.
2
Inhaled glucocorticoids
O4.
Inhaled combination therapy
O4.
1
Inhaled glucocorticoids and long-acting beta-agonists in combination
O4.
2
Inhaled glucocorticoids and long-acting beta-agonists and long-acting anticholinergics in combination
O5:
Inhaler technique
O6:
Non-pharmacological interventions
O6.
1
Physical activity
O6.
2
Exercise training
O6.
3
Education and self-management
O6.
3.1
Psychosocial support
O6.
4
Pulmonary rehabilitation
O6.
5
Chest physiotherapy (Airway clearance techniques)
O6.
6
Nutrition
O7.
Co-morbidities & drug safety
O7.
1
Aspiration
O7.
2
Gastro-oesophageal reflux
O7.
3
Alcohol and sedatives
O7.
4
Sleep related breathing disorders
O7.
5
Osteoporosis
O8.
Hypoxaemia and pulmonary hypertension
O8.
1
Treatment
O9.
Surgery
O9.
1
Bullectomy
O9.
2
Lung volume reduction surgery
O9.
3
Lung transplantation
O10.
Palliation and end of life
O10.
1
Opioids
O10.
2
Advanced Care Plans
O10.
3
Palliative oxygen therapy for dyspnoea
P: Prevent deterioration
P1.
Risk factor reduction
P1.
1
Smoking cessation
P1.
1.1
Nicotine replacement therapy
P1.
1.2
Bupropion
P1.
2
Prevent smoking relapse
P2.
Influenza vaccination
P3.
Pneumococcal vaccination
P4.
Haemophilus influenzae vaccination
P5.
Immuno-modulatory agents
P6.
Antibiotics
P7.
Anticholinergics
P8.
Glucocorticoids
P9.
Mucolytic agents
P10.
Regular review
P11.
Oxygen therapy
P11.
1
Fitness to fly
D: Develop support network and self-management plan
D1.
Support team
D1.
1
General
D1.
2
Nurse/respiratory educator
D1.
3
Physiotherapist
D1.
4
Occupational therapist
D1.
5
Social worker
D1.
6
Clinical psychologist
D1.
7
Speech pathologist/therapist
D1.
8
Pharmacist
D1.
9
Dietitian
D1.
10
Non-medical care agencies
D2.
Multidisciplinary care plans
D3.
Self-management plans
D3.
1
Maintenance therapy
D3.
2
Exacerbations and crises
D4.
Treat anxiety and depression
D5.
Referral to a support group
D6.
End-of-life issues
X: Manage eXacerbations
X1.
Home management
X2.
COPD acute exacerbation plan
X2.
1
Initial assessment of severity
X2.
2
Optimise treatment
X3.
Refer appropriately to prevent further deterioration (‘P’)
X3.
1
Controlled oxygen delivery
X3.
2
Non-invasive positive pressure ventilation
X3.
3
Invasive ventilation (intubation)
X3.
4
Clearance of secretions
X3.
5
Monitor and review
X3.
6
Pulmonary rehabilitation
X3.
7
Discharge planning
X3.
8
Support after discharge
X3.
9
Clinical review and follow-up
Appendices
Appendix 1
Appendix 2
Appendix 3
Initiating oxygen therapy
What the patient needs to know
Review
Dangers
Choosing the right method
References
References 1 - 50
References 51 - 100
References 101 - 150
References 151 - 200
References 201 - 251
References 251 - 286
References reviewed but not cited
Content last updated:
April 2009
Page last updated:
April 14, 2009
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