title: COPD control: Can a consensus be found?
abstract: There are currently no reliable instruments for assessing the onset and progression of chronic obstructive pulmonary disease (COPD) or predicting its prognosis. Currently, a comprehensive assessment of COPD including several objective and subjective parameters is recommended. However, the lack of biomarkers precludes a correct assessment of COPD severity, which consequently hampers adequate therapeutic approaches and COPD control. In the absence of a definition of "well-controlled disease", a consensus regarding COPD control will be difficult to reach. However, COPD patient assessment should be multidimensional, and anchored in five points: control of symptoms, decline of pulmonary function, levels of physical activity, exacerbations, and Quality of Life. Several non-pharmacological and pharmacological measures are currently available to achieve disease control. Smoking cessation, vaccination, exercise training programs and pulmonary rehabilitation are recognized as important non-pharmacological measures but bronchodilators are the pivotal therapy in the control of COPD. This paper discusses several objective and subjective parameters that may bridge the gap between disease assessment and disease control. The authors conclude that, at present, it is not possible to reach a consensus regarding COPD control, essentially due to the lack of objective instruments to measure it. Some recommendations are set forth, but true COPD control awaits further objective assessments.
authors.affiliation: Pulmonology Department, Centro Hospitalar Gaia-Espinho, EPE, Portugal. Electronic address: m.guimaraes75@gmail.com.
authors.forename: M
authors.initials: M
authors.lastname: Guimarães
authors.affiliation: Pulmonology Department, Hospital CUF Infante Santo/Hospital CUF Descobertas, Lisbon, Portugal; Chronic Diseases Research Center (CEDOC), Lisbon School of Medical Sciences, Nova University, Lisbon, Portugal. Electronic address: antonio.bugalho@gmail.com.
authors.forename: A
authors.initials: A
authors.lastname: Bugalho
authors.affiliation: Pulmonology Department, Hospital Pulido Valente, CHLN, Lisbon, Portugal. Electronic address: depitadas2@gmail.com.
authors.forename: A S
authors.initials: AS
authors.lastname: Oliveira
authors.affiliation: General Hospital, Coimbra University Hospital Center, Portugal. Electronic address: joaquimmmoita@gmail.com.
authors.forename: J
authors.initials: J
authors.lastname: Moita
authors.affiliation: Pulmonology Department, São João Hospital Center, Oporto Medical School, Porto, Portugal. Electronic address: marquesa@med.up.pt.
authors.forename: A
authors.initials: A
authors.lastname: Marques
mesh_terms: D032921:Consensus; D006801:Humans; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000628:therapy*
keywords: COPD; COPD assessment; Control; Spirometry; Symptoms control; Treatment