Monitoring of patients with COPD: a review of current guidelines' recommendations.
BACKGROUND
The goals for the management of COPD are to delay the process of disease progression and alleviate its manifestations. The follow-up of the patients' physical and mental condition is part of best practice management when monitoring routines results in information that contributes to the achievement of management goals. However, the recommendations on monitoring procedures may differ between guidelines and may not be based on scientific evidence. The aim of this article is to review the current guideline recommendations on monitoring routines for COPD.


METHODS
Clinical practice guidelines on the management of COPD were identified by a Medline search, Internet search and expanded by experts in the respiratory field. Guidelines on the management of COPD were analysed on recommended monitoring routines, recommended frequency of monitoring.


RESULTS
Eighteen clinical practice guidelines on the management of COPD were analysed. The follow-up of lung function indices was the most frequently recommended monitoring routine. Moreover, monitoring of symptoms, exercise tolerance, comorbidity, and smoking habits were recommended regularly. In none of the guidelines, the recommended monitoring routines were evidence based. Only one guideline provides a different set of monitoring parameters for advanced COPD compared to mild and moderate COPD.


CONCLUSIONS
Some monitoring routines were recommended frequently, especially follow-up of lung function indices. However, evidence to support the guideline recommendations for the monitoring of patients with COPD is missing. The effect of monitoring on care process and outcomes should be assessed.
van den Bemt
Lisette
L
Radboud University Nijmegen Medical Centre, Department of General Practice (route 117), P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands. L.vandenbemt@hag.umcn.nl
Schermer
Tjard
T
Smeele
Ivo
I
Bischoff
Erik
E
Jacobs
Annelies
A
Grol
Richard
R
van Weel
Chris
C
D015897:Comorbidity; D019317:Evidence-Based Medicine; D017079:Exercise Tolerance; D019983:Guideline Adherence; D006801:Humans; D017410:Practice Guidelines as Topic; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology / Q000628:therapy*; D012129:Respiratory Function Tests; D012907:Smoking