[The revised Dutch College of General Practitioners' standard on COPD and the first international WHO standard: differences and similarities].
Two standards on COPD have recently been published: the revised national standard from the Dutch College of General Practitioners and the first international standard published by the World Health Organization and the US National Heart, Lung and Blood Institute. The reduced emphasis on the role of spirometry in the monitoring and evaluation of treatment is an important change in these new standards compared to previous ones. Cessation of smoking is considered to be central to the prevention and treatment of COPD. Doctors should strongly support this approach and, more than before, are urged to view COPD as a disease caused by addiction. Bronchodilators are the cornerstone of symptomatic treatment of COPD, particularly the long-acting ones due to their ease of administration and effective treatment of morning dyspnoea. Inhalation corticosteroids should only be administered as a trial treatment and only under certain conditions. Continuation of treatment with these agents is only justified if there is a demonstrated improvement in lung function, exacerbations or symptoms, although the precise area of indication is not yet clear.
van Schayck
C P
CP
Universiteit Maastricht, Onderzoeksinstituut ExTra, Postbus 616, 6200 MD Maastricht. onno.vanschayck@hag.unimaas.nl
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D001993:Bronchodilator Agents / Q000627:therapeutic use; D006801:Humans; D007391:International Cooperation; D009426:Netherlands; D017410:Practice Guidelines as Topic / Q000592:standards*; D029424:Pulmonary Disease, Chronic Obstructive / Q000517:prevention & control / Q000628:therapy*; D016540:Smoking Cessation; D012955:Societies, Medical; D013147:Spirometry; D014944:World Health Organization
D000305:Adrenal Cortex Hormones; D001993:Bronchodilator Agents