Management of the COPD patient with comorbidities: an experts recommendation document

Recio Iglesias J ; Díez-Manglano J (Universidad de Zaragoza) ; Lopez Garcia F ; Diaz Peromingo JA ; Almagro P ; Varela Aguilar JM

Resumen: 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

Idioma: Inglés

DOI: 10.2147/COPD.S242009

Año: 2020

Publicado en: International journal of chronic obstructive pulmonary disease 15 (2020), 1015 - 1037
ISSN: 1176-9106

Factor impacto JCR: 3.355 (2020)

Categ. JCR: RESPIRATORY SYSTEM rank: 30 / 64 = 0.469 (2020) - Q2 - T2

Factor impacto SCIMAGO: 1.393 - Health Policy (Q1) - Pulmonary and Respiratory Medicine (Q1) - Public Health, Environmental and Occupational Health (Q1) - Medicine (miscellaneous) (Q1)

Tipo y forma: Artículo (Versión definitiva)

Área (Departamento): Area Medicina (Dpto. Medicina, Psiqu. y Derm.)