Family physicians’ approach to COPD according to GOLD guidelines 2013

Öz

Chronic Obstructive Pulmonary Disease (COPD) is a preventable disease state, characterized by progressive airflow limitation. COPD is a major health problem, causing a progressive rise in health care spending in both developed and developing countries. According to 2020 projection of the World Health Organization (WHO), COPD is expected to be the 5th cause of illness and disability, and the 6th leading cause of death worldwide. Although smoking is accepted as the most important risk factor for COPD according to the GOLD (Global Initiative for Chronic Obstructive Lung Disease) 2013 report, different entities such as occupational exposure, socio-economic status and genetic predisposition may also play an important role in varying contributions. Therefore, efficient and accurate approach of family physicians to COPD in primary care is very important

Anahtar Kelimeler

• Chronic Obstructive Pulmonary Disease
• GOLD 2013 guideline
• family physician

GOLD 2013 rehberine göre aile hekimliği sisteminde KOAH'a yaklaşım

Öz

Kronik obstrüktif akciğer hastalığı (KOAH) önlenebilir bir hastalık olup, ilerleyici hava akım kısıtlılığı ile karakterizedir. KOAH, gerek gelişmiş gerekse de gelişmekte olan ülkelerde sağlık harcamalarında giderek artan ve büyük bir paya sahip olması nedeniyle önemli bir sağlık sorunu oluşturmaktadır. Dünya Sağlık Örgütü (DSÖ) öngörülerine göre, 2020 yılında KOAH’ın bütün dünyada 5.hastalık ve sakatlık nedeni olurken, mortalitenin de 6. sebebi olacağı beklenmektedir. GOLD (Global Initiative for Chronic Obstructive Lung Disease) 2013 raporuna rehberine göre hastalığın ortaya çıkmasında en önemli risk faktörünün sigara olduğu kabul edilse de; KOAH mesleki maruziyet, sosyoekonomik durum ve genetik yatkınlık gibi değişik öyküler durumlar sonucunda oluşan bir hastalıktır ve her bir bireyde rol alan nedenlerin etkinliği farklılık gösterir. Bundan dolayı günümüzün birinci basamak sağlık hizmetinin verildiği aile hekimliği sisteminde KOAH’a doğru ve etkili yaklaşım önem taşımaktadır

Anahtar Kelimeler

• Kronik obstrüktif akciğer hastalığı
• GOLD 2013 rehberi
• aile hekimliği

Kaynakça

1. -
2. http://www.goldcopd.org/uploads/users/files/GOLD Report 2013 Feb20. pdf
3. Murray CJ, Lopez AD. Alternative projections of mortality and disability by cause 1990-2020: Global Burden of Disease Study. Lancet 1997; 349: 1498-1504.
4. Tatlıcıoglu T. Kronik obstrüktif akciger hastalıgı (KOAH) ve gelecegi. Tüberküoz ve Toraks Dergisi 2007; 55: 303-318. 4. Celli BR, Halbert RJ, Nordyke RJ, Schan B. Airway obstruction in never smokers: results from the Third National Health and Nutrition Examination Survey. Am J Med 2005; 118: 1364-1372.
5. Fletcher C, Peto R, The natural history of chronic airflow obstruction. Br Med J 1977; 1: 1645-1648.
6. Prescott E. Tobacco related diseases:the role of gender. Dan Med Bull 2000; 47: 115-131.
7. Kömüs N, Albayrak S, Ellidokuz H, Çimrin AH, Mesleksel, çevresel mazuriyetler ve akciğer sağlığı ilişkisi. Tuberk Toraks 2008; 56: 275-282.
8. Oroczo-Levi M. Garcia-Aymerich J, Villar J, et al. Wood smoke exposure and risk of chronic obstructive pulmonary disease. Eur Respir J 2006; 27: 542-546.

9. Sezer H, Akkurt I, Guler N, Marakoğlu K, Berk S. A case- control study on the effect of exposure to different substances on the development of COPD. Ann Epidemiol 2006; 16: 59- 62.
10. Günay S, Günay E, Sönmez Ö. KOAH tanılı hastalarda solunumsal maruziyetler ile hastalık arasındaki ilişkinin incelenmesi. Turkish Journal of Geriatrics 2013; 16(3): 243- 252.
11. Stoller JK, Aboussouan LS. Alpha-1 antitrypsin deficiency. Lancet 2005; 365: 2225-2236.
12. Hogg JC. Pathophysiology of airflow limitation in chronic obstructive pulmonary disease. Lancet 2004; 364: 709-721.
13. Senior RM, Shapiro SD. Chronic obstructive pulmonary disease: Epidemiology, pathophysiology and pathogenesis In: Fishman AP, Elias JA, Fishman JA, Grippi MA, Kaiser LR, Senior RM, eds. Fishman’s Pulmonary Disease and Disorders. New York, Mc Graw Hill 1998: 659-682.
14. Paré PD, Bai TR. Airway wall remodelling in chronic obstructive pulmonary disease. Eur Respir Rev 1996; 39(6): 259-263.
15. Barnes PJ, Shapiro SD, Pauwels RA. Chronic obstructive pulmonary disease: molecular and cellular mechanisms. Eur Respir J 2003; 22: 672-688.
16. Soriano JB, Visick GT, Muellerova H, Payvandi N, Hansell AL. Patterns of co-morbidities in newly diagnosed COPD and asthma in primary care. Chest 2005; 128: 2099- 2107.
17. Siafakas NM, Vermeire P, Pride NB. Optimal assesment and management of COPD. Eur Respir J, 1995; 8: 1398-1420. 18. Pare PD, Wiggs BR, James A, Hogg JC, Bosken C. The comperative mechanics and morphology of airways in asthma and chronic obstructive pulmonary disease. Am Rev Respir Dis 1991; 143: 1189-1193.
18. Quanjer PH, TammelingGJ, Cotes JE, Pedersen OF, Peslin R, Yernault JC. Lung volumes and forced ventilatory flows. Eur Respir J 1993; 6(Suppl 16): 5-40.
19. Erk M. Kronik obstrüktif akciğer hastalığında yapısal değişikliklerin akciğer fonksiyonları ile ilişkisi. Toraks Dergisi 2000; 1: 71-76.
20. Ferrer M, Alonso J, Morera J, Marrades RM, Khalaf A, Aguar MC, Plaza V, Prieto L, Antó JM. Chronic obstructive pulmonary disease and health related quality of life. Ann Int Med 1997; 127: 1072–1079.
21. Celli B, Halbert R, Isonaka S, Schau B. Population impact of different definitions of airway obstruction. Eur Respir J 2003; 22: 268–273.
22. Blanc PD, Toren K. Occupation in chronic obstructive pulmonary disease and chronic bronchitis: an update. Int J Tuberc Lung Dis 2007; 11: 251-257.
23. Lippmann M. Health effects of airborne particulate matter. N Engl J Med 2007; 357: 2395-2402.
24. Tonnesen P, Carrozzi L, Fagerstrom KO, Gratziou C, Jimenez-Ruiz C, Nardini S, Viegi G, Lazzaro C, Campell IA, Dagli E, West R. Smoking cessation in patients with respiratory diseases: a high priority, integral component of therapy. Eur Respir J 2007; 29: 390-417.
25. Jenkins CR, Jones PW, Calverley PM, Celli B, Anderson JA, Ferguson GT, Yates JC, Willits LR, Vestbo J. Efficacy of salmeterol/fluticasone propionate by GOLD stage of chronic obstructive pulmonary disease: analysis from the randomised, placebo-controlled TORCH study. Respir Res. 2009; 10: 59- 68.
26. Calverley PMA. Symptomatic bronchodilator treatment. In Calverley PMA, Pride NB, eds. Chronic obstructive pulmonary disease. London: Chapman and Hall 1995: 419- 45.
27. Restrepo RD. Use of inhaled anticholinergic agents in obstructive airway disease. Respir Care 2007; 52: 833-851.
28. Mahler DA. The effect of inhaled β2-agonists on clinical outcomes in chronic obstructive pulmonary disease. J Allergy Clin Immunol 2002; 110: 298-303.
29. Umut S, Gemicioglu B, Yildirim N, Barlas, Ozuner Z. Effect of theophylline in chronic obstructive lung disease. International Journal of Clinicial Pharmacology and Therapeutic Toxicology 1992; 30: 149-152.
30. Welte T. Optimizing treatment for COPD: new strategies for combination therapy. Int J Clin Pract 2009; 63: 1136-1149. 32. Yang IA, Fong KM, SimEH, Black PN, Lasserson TJ. Inhaled coricosteroids for stable chronic obstructive pulmonary disease. Cochrane Database Syst Rev 2007;18: 2: CD002991.
31. ATS/ERS Statement on Pulmonary Rehabilitation. Am J Respir Crit Care Med 2006; 173: 1390-1413.
32. Sapey E, Stockley RA. COPD exacerbations . Aetiology. Thorax 2006; 61: 250-258.