Guidelines for the management of chronic obstructive pulmonary disease. Working Group of the South African Pulmonology Society.
OBJECTIVE
This guideline has been developed in order to optimise the management of patients with chronic obstructive pulmonary disease (COPD) at all levels of the health care system in South Africa. It contains an action plan for early recognition and appropriate treatment of this common condition.


METHODS
Treatment regimens are recommended for patients with mild (stage I), moderate (stage II) and severe (stage III) disease.


RESULTS
Optimal management of patients with COPD may achieve a reduction in breathlessness, improved quality of life, prevention of complications and limitation of disease progression.


METHODS
The Working Group comprised mainly pulmonologists, but included an anaesthetist, a pharmacologist and a physiotherapist. Detailed literature review with particular attention to similar guideline documents from Europe and the USA was performed before the meeting.


CONCLUSIONS
Steps in the management of patients with COPD include early recognition of the disease, smoking cessation, treatment of airflow obstruction with appropriate drugs (singly or in combination), education and pulmonary rehabilitation, and limitation of disease progression and complications. detailed recommendations are made with regard to the use and interpretation of a trial of oral corticosteroid therapy. Indications for hospitalisation, intensive care unit admission and ventilatory support are provided.


RESULTS
This guideline is similar to those recommended by other groups outside South Africa. It was developed by a working group of the South African Pulmonology Society and is endorsed by the Medical Association of South Africa.


BACKGROUND
The meeting of the Working Group was sponsored by Boehringer Ingelheim. This sponsorship did not influence the activities of the Group.
D018450:Disease Progression; D006801:Humans; D008173:Lung Diseases, Obstructive / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D010102:Oxygen Inhalation Therapy; D010353:Patient Education as Topic; D011788:Quality of Life; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D016540:Smoking Cessation; D013019:South Africa; D013147:Spirometry