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2015 ; 147
(4
): 894-942
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Prevention of acute exacerbations of COPD: American College of Chest Physicians
and Canadian Thoracic Society Guideline
#MMPMID25321320
Criner GJ
; Bourbeau J
; Diekemper RL
; Ouellette DR
; Goodridge D
; Hernandez P
; Curren K
; Balter MS
; Bhutani M
; Camp PG
; Celli BR
; Dechman G
; Dransfield MT
; Fiel SB
; Foreman MG
; Hanania NA
; Ireland BK
; Marchetti N
; Marciniuk DD
; Mularski RA
; Ornelas J
; Road JD
; Stickland MK
Chest
2015[Apr]; 147
(4
): 894-942
PMID25321320
show ga
BACKGROUND: COPD is a major cause of morbidity and mortality in the United States
as well as throughout the rest of the world. An exacerbation of COPD (periodic
escalations of symptoms of cough, dyspnea, and sputum production) is a major
contributor to worsening lung function, impairment in quality of life, need for
urgent care or hospitalization, and cost of care in COPD. Research conducted over
the past decade has contributed much to our current understanding of the
pathogenesis and treatment of COPD. Additionally, an evolving literature has
accumulated about the prevention of acute exacerbations. METHODS: In recognition
of the importance of preventing exacerbations in patients with COPD, the American
College of Chest Physicians (CHEST) and Canadian Thoracic Society (CTS) joint
evidence-based guideline (AECOPD Guideline) was developed to provide a practical,
clinically useful document to describe the current state of knowledge regarding
the prevention of acute exacerbations according to major categories of prevention
therapies. Three key clinical questions developed using the PICO (population,
intervention, comparator, and outcome) format addressed the prevention of acute
exacerbations of COPD: nonpharmacologic therapies, inhaled therapies, and oral
therapies. We used recognized document evaluation tools to assess and choose the
most appropriate studies and to extract meaningful data and grade the level of
evidence to support the recommendations in each PICO question in a balanced and
unbiased fashion. RESULTS: The AECOPD Guideline is unique not only for its topic,
the prevention of acute exacerbations of COPD, but also for the first-in-kind
partnership between two of the largest thoracic societies in North America. The
CHEST Guidelines Oversight Committee in partnership with the CTS COPD Clinical
Assembly launched this project with the objective that a systematic review and
critical evaluation of the published literature by clinical experts and
researchers in the field of COPD would lead to a series of recommendations to
assist clinicians in their management of the patient with COPD. CONCLUSIONS: This
guideline is unique because it provides an up-to-date, rigorous, evidence-based
analysis of current randomized controlled trial data regarding the prevention of
COPD exacerbations.