Management of the COPD Patient with Comorbidities: An Experts Recommendation Document.
COPD
Delphi technique
chronic obstructive pulmonary disease
comorbidities
modified RAND-UCLA
Journal
International journal of chronic obstructive pulmonary disease
ISSN: 1178-2005
Titre abrégé: Int J Chron Obstruct Pulmon Dis
Pays: New Zealand
ID NLM: 101273481
Informations de publication
Date de publication:
2020
2020
Historique:
received:
11
12
2019
accepted:
10
03
2020
entrez:
23
5
2020
pubmed:
23
5
2020
medline:
29
6
2021
Statut:
epublish
Résumé
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. To elaborate expert recommendations aimed to help healthcare professionals to provide the right care for treating COPD patients with comorbidities. 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. 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. 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.
Sections du résumé
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.
Identifiants
pubmed: 32440113
doi: 10.2147/COPD.S242009
pii: 242009
pmc: PMC7217705
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1015-1037Informations de copyright
© 2020 Recio Iglesias et al.
Déclaration de conflit d'intérêts
Jesús Recio Iglesias has received speaker or consulting fees from Boehringer Ingelheim, Chiesi, Ferrer and Novartis unrelated to this manuscript. Jesús Díez Manglano has received speaker or consulting fees from Bayer, Bristol-Myers-Squibb, Chiesi, and Novartis unrelated to this manuscript. Francisco López García has received speaker or consulting fees from Boehringer Ingelheim, Chiesi, GSK and Novartis unrelated to this manuscript. José Antonio Díaz Peromingo has received speaker or clinical trials fees from Boehringer, Chiesi, Bayer, Bristol, Novartis, Faes, GSK and Sanofi. Pere Almagro Mena has received grants from Astra Zeneca and SEPAR, personal fees from Chiesi, Boehringer Ingelheim and GSK and travel support from Rovi and Esteve, outside the submitted work. Jose Manuel Varela Aguilar has received speaker or consulting fees from Astra Zeneca, Boehringer Ingelheim, Chiesi, GSK, Menarini, Novartis, Novo Nordisk and Rovi. The authors report no other conflicts of interest in this work.
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