title: Chronic Obstructive Pulmonary Disease: official diagnosis and treatment guidelines of the Czech Pneumological and Phthisiological Society; a novel phenotypic approach to COPD with patient-oriented care.
abstract: BACKGROUND
  COPD is a global concern. Currently, several sets of guidelines, statements and strategies to managing COPD exist around the world.
  
  
  METHODS
  The Czech Pneumological and Phthisiological Society (CPPS) has commissioned an Expert group to draft recommended guidelines for the management of stable COPD. Subsequent revisions were further discussed at the National Consensus Conference (NCC). Reviewers' comments contributed to the establishment of the document's final version.
  
  
  METHODS
  The hallmark of the novel approach to COPD is the integrated evaluation of the patient's lung functions, symptoms, exacerbations and identifications of clinical phenotype(s). The CPPS defines 6 clinically relevant phenotypes: frequent exacerbator, COPD-asthma overlap, COPD-bronchiectasis overlap, emphysematic phenotype, bronchitic phenotype and pulmonary cachexia phenotype.
  
  
  METHODS
  Treatment recommendations can be divided into four steps. 1(st) step = Risk exposure elimination: reduction of smoking and environmental tobacco smoke (ETS), decrease of home and occupational exposure risks. 2(nd) step = Standard treatment: inhaled bronchodilators, regular physical activity, pulmonary rehabilitation, education, inhalation training, comorbidity treatment, vaccination. 3(rd) step = Phenotype-specific therapy: PDE4i, ICS+LABA, LVRS, BVR, AAT augmentation, physiotherapy, mucolytic, ABT. 4(th) step = Care for respiratory insufficiency and terminal COPD: LTOT, lung transplantation, high intensity-NIV and palliative care.
  
  
  CONCLUSIONS
  Optimal treatment of COPD patients requires an individualised, multidisciplinary approach to the patient's symptoms, clinical phenotypes, needs and wishes. The new Czech COPD guideline reflects and covers these requirements.
authors.affiliation: Pulmonary Department, Faculty of Medicine in Hradec Kralove, Charles University in Prague and University Hospital Hradec Kralove, Czech Republic. vladimir.koblizek@fnhk.cz
authors.forename: Vladimir
authors.initials: V
authors.lastname: Koblizek
authors.forename: Jan
authors.initials: J
authors.lastname: Chlumsky
authors.forename: Vladimir
authors.initials: V
authors.lastname: Zindr
authors.forename: Katerina
authors.initials: K
authors.lastname: Neumannova
authors.forename: Jakub
authors.initials: J
authors.lastname: Zatloukal
authors.forename: Jaroslav
authors.initials: J
authors.lastname: Zak
authors.forename: Vratislav
authors.initials: V
authors.lastname: Sedlak
authors.forename: Jana
authors.initials: J
authors.lastname: Kocianova
authors.forename: Jaromir
authors.initials: J
authors.lastname: Zatloukal
authors.forename: Karel
authors.initials: K
authors.lastname: Hejduk
authors.forename: Sarka
authors.initials: S
authors.lastname: Pracharova
mesh_terms: D032921:Consensus; D018153:Czech Republic; D006801:Humans; D010347:Patient Care Planning; D018802:Patient-Centered Care; D029424:Pulmonary Disease, Chronic Obstructive / Q000145:classification / Q000175:diagnosis / Q000628:therapy*; D015272:Pulmonary Medicine; D012955:Societies, Medical