Chronic obstructive pulmonary disease--can we do better?
Chronic obstructive pulmonary disease (COPD) is extremely common; all primary care physicians should be able to manage this disorder. Probably 30 million Americans are afflicted with some stage of the disease. Assessment of COPD is based on symptoms and simple spirometric measurements that primary care physicians can perform in their offices. Early identification and intervention are vital to controlling COPD. Smoking cessation is most important. Aggressive pharmacologic therapy is also required. Bronchoactive drugs are more successful in improving airflow in patients in early stages of the disease than those with more advanced stages. The National Mucolytic Study Investigators' Meeting, focusing on the usage of iodinated glycerol (Organidin) in patients with moderate-to-advanced airflow obstruction from chronic bronchitis, has concluded that symptoms of the disease were improved in treated patients compared with patients receiving placebo. These results, based on a major double-blind, controlled clinical trial, will usher in a new approach to the treatment of patients with mucus clearance problems. It is now time to develop a nationwide strategy for involving all primary care physicians in the identification and treatment of patients with COPD.
Department of Academic and Research Affairs, Presbyterian St Luke's Center for Health Sciences Education, Denver.
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D006801:Humans; D008173:Lung Diseases, Obstructive / Q000175:diagnosis / Q000628:therapy