130359 20240124152851.0 doi 10.2147/COPD.S242009 sideral 136416 ART-2020-136416 eng Recio Iglesias J Management of the COPD patient with comorbidities: an experts recommendation document 2020 Background: Chronic obstructive pulmonary disease (COPD) is associated with multiple comorbidities, which impact negatively on patients and are often underdiagnosed, thus lacking a proper management due to the absence of clear guidelines. Purpose: To elaborate expert recommendations aimed to help healthcare professionals to provide the right care for treating COPD patients with comorbidities. Methods: A modified RAND-UCLA appropriateness method consisting of nominal groups to draw up consensus recommendations (6 Spanish experts) and 2-Delphi rounds to validate them (23 Spanish experts) was performed. Results: A panel of Spanish internal medicine experts reached consensus on 73 recommendations and 81 conclusions on the clinical consequences of the presence of comorbidities. In general, the experts reached consensus on the issues raised with regard to cardiovascular comorbidity and metabolic disorders. Consensus was reached on the use of selective serotonin reuptake inhibitors in cases of depression and the usefulness of referring patients with anxiety to respiratory rehabilitation programmes. The results also showed consensus on the usefulness of investigating the quality of sleep, the treatment of pain with opioids and the evaluation of osteoporosis by lateral chest radiography. Conclusion: This study provides conclusions and recommendations that are intended to improve the management of the complexity of patients with COPD and important comorbidities, usually excluded from clinical trials. Keywords: chronic obstructive pulmonary disease, COPD, comorbidities, modified RANDUCLA, Delphi technique Access copy available to the general public Unrestricted info:eu-repo/semantics/openAccess by-nc http://creativecommons.org/licenses/by-nc/3.0/es/ 3.355 2020 RESPIRATORY SYSTEM 30 / 64 = 0.469 2020 Q2 T2 1.393 2020 Health Policy 2020 Q1 Pulmonary and Respiratory Medicine 2020 Q1 Public Health, Environmental and Occupational Health 2020 Q1 Medicine (miscellaneous) 2020 Q1 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Díez-Manglano J Universidad de Zaragoza (orcid)0000-0002-3132-2171 Lopez Garcia F Diaz Peromingo JA Almagro P Varela Aguilar JM 1007 610 Universidad de Zaragoza Dpto. Medicina, Psiqu. y Derm. Area Medicina 15 (2020), 1015 - 1037 Int. j. chronic obstr. pulm. dis. International journal of chronic obstructive pulmonary disease 1176-9106 859415 http://zaguan.unizar.es/record/130359/files/texto_completo.pdf Versión publicada 2427702 http://zaguan.unizar.es/record/130359/files/texto_completo.jpg?subformat=icon icon Versión publicada oai:zaguan.unizar.es:130359 articulos driver 2024-01-24-15:05:17 ARTICLE