title: The concept of control of COPD in clinical practice.
abstract: Treatment of chronic obstructive pulmonary disease (COPD) requires a personalized approach according to the clinical characteristics of the patients, the level of severity, and the response to the different therapies. Furthermore, patients with the same level of severity measured by the degree of airflow obstruction or even with multidimensional indices may have very different symptoms and limitations for daily activities. The concept of control has been extensively developed in asthma but has not been defined in COPD. Here, we propose a definition of COPD control based on the concepts of impact and stability. Impact is a cross-sectional concept that can be measured by questionnaires such as the COPD Assessment Test or the Clinical COPD Questionnaire. Alternatively, impact can be assessed by the degree of dyspnea, the use of rescue medication, the level of physical activity, and sputum color. Stability is a longitudinal concept that requires the absence of exacerbations and deterioration in the aforementioned variables or in the COPD Assessment Test or Clinical COPD Questionnaire scores. Control is defined by low impact (adjusted for severity) and stability. The concept of control in COPD can be useful in the decision making regarding an increase or decrease in medication in the stable state.
authors.affiliation: Pneumology Department, Hospital Arnau de Vilanova, Valencia, Spain ; CIBER de Enfermedades Respiratorias (CIBERES), Hospital de Alta Resolucion, Granada, Spain.
authors.forename: Juan José
authors.initials: JJ
authors.lastname: Soler-Cataluña
authors.affiliation: Respiratory Department, Hospital de Alta Resolucion, Granada, Spain.
authors.forename: Bernardino
authors.initials: B
authors.lastname: Alcázar-Navarrete
authors.affiliation: CIBER de Enfermedades Respiratorias (CIBERES), Hospital de Alta Resolucion, Granada, Spain ; Pneumology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
authors.forename: Marc
authors.initials: M
authors.lastname: Miravitlles
mesh_terms: D018450:Disease Progression; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D010641:Phenotype; D011237:Predictive Value of Tests; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D020127:Recovery of Function; D012129:Respiratory Function Tests; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
keywords: CAT; CCQ; COPD; control; exacerbations; prognosis