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Feature Article

Managing COPD: what the GP needs to know

Peter Frith

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Abstract

Chronic obstructive pulmonary disease is becoming an increasingly important problem in Australia as our population ages. Its treatment is a good example of disease management as all the stages of the condition and its complications need to be addressed.

Key Points

  • Think of COPD in all adults with cough or who are breathless with exertion – especially if they have been smokers.
  • People in middle age who notice breathing difficulties may incorrectly attribute them to advancing years or lack of fitness.
  • COPD is often a systemic disorder, with many complications and concurrent morbidities.
  • Early diagnosis can be achieved with spirometry, and early intervention with risk factor reduction can achieve significant long term benefits.
  • Smoking is the main risk factor. Doctors should aim to identify all smokers in their practice and initiate stop smoking programs as soon as possible.
  • Bronchodilators can relieve symptoms; metered dose devices are preferred.
  • Inhaled corticosteroids do not modify the disease. Systemic corticosteroids shorten the recovery from exacerbations.
  • Pulmonary rehabilitation is highly effective at improving wellbeing and functionality at all stages of the disorder.

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