8/11/19 1 Patrick A. Laird, DNP, APRN, ACNP-BC, NEA-BC COPD: THE WHO, WHAT, WHEN, AND WHY OF MANAGEMENT DISCLOSURES • I have no actual or potential conflict of interest in relation to this presentation. OBJECTIVES • Review the pathophysiology of chronic obstructive pulmonary disease (COPD). • Describe the role of pulmonary function tests (PFTs) in the diagnosis of COPD. • Describe the comprehensive management of patients with a moderate to severe COPD exacerbation. CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) • Chronic Obstructive Pulmonary Disease (COPD) is the 4 th leading cause of death worldwide. • COPD is expected to rise to the 3 rd leading cause of death by 2020. • In 2012, 6% of all deaths were attributed to COPD. CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) • 384 million COPD cases estimated in 2010. • Three million deaths annually. • Predicted 4.5 million COPD related deaths by 2030 ECONOMIC BURDEN • COPD exacerbations account for the majority of total economic burden • Direct costs of COPD in US -- $32 billion • Indirect costs of COPD in US -- $20.4 billion
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8/11/19
1
Patrick A. Laird, DNP, APRN, ACNP-BC, NEA-BC
COPD: THE WHO, WHAT, WHEN, AND WHY OF
MANAGEMENT
DISCLOSURES
• I have no actual or potential conflict of interest in relation to this presentation.
OBJECTIVES
• Review the pathophysiology of chronic obstructive pulmonary disease (COPD).
• Describe the role of pulmonary function tests (PFTs) in the diagnosis of COPD.
• Describe the comprehensive management of patients with a moderate to severe COPD exacerbation.
CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD)
• Chronic Obstructive Pulmonary Disease (COPD) is the 4th
leading cause of death worldwide.
• COPD is expected to rise to the 3rd leading cause of death by 2020.
• In 2012, 6% of all deaths were attributed to COPD.
CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD)
• 384 million COPD cases estimated in 2010.• Three million deaths annually.
• Predicted 4.5 million COPD related deaths by 2030
ECONOMIC BURDEN
• COPD exacerbations account for the majority of total economic burden
• Direct costs of COPD in US -- $32 billion• Indirect costs of COPD in US -- $20.4 billion
• COPD is a common, preventable, and treatable disease that is characterized by persistent respiratory symptoms and airflow limitation that is due to airway and/or alveolar abnormalities usually caused by significant exposure to noxious particles or gases.
• Division of Population Health | CDC. (2019, June 28). Retrieved August 7, 2019, from https://www.cdc.gov/nccdphp/dph/index.html
• Eisner, M. D., Anthonisen, N., Coultas, D., Kuenzli, N., Perez-Padilla, R., Postma, D., … Committee on Nonsmoking COPD, Environmental and Occupational Health Assembly. (2010). An official American Thoracic Society public policy statement: Novel risk factors and the global burden of chronic obstructive pulmonary disease. American Journal of Respiratory and Critical Care Medicine, 182(5), 693–718. https://doi.org/10.1164/rccm.200811-1757ST
• GOLD-2019-v1.7-FINAL-14Nov2018-WMS.pdf. (n.d.). Retrieved from https://goldcopd.org/wp-content/uploads/2018/11/GOLD-2019-v1.7-FINAL-14Nov2018-WMS.pdf
• Hopkinson, N. S., Molyneux, A., Pink, J., Harrisingh, M. C., & Guideline Committee (GC). (2019). Chronic obstructive pulmonary disease: Diagnosis and management: summary of updated NICE guidance. BMJ (Clinical Research Ed.), 366, l4486. https://doi.org/10.1136/bmj.l4486
• McCormack, M. (n.d.). Overview of pulmonary function testing in adults—UpToDate. Retrieved August 2, 2019, from https://www.uptodate.com/contents/overview-of-pulmonary-function-testing-in-adults?search=pulmonary%20function%20tests%20adult&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1
• Press, V. G., Au, D. H., Bourbeau, J., Dransfield, M. T., Gershon, A. S., Krishnan, J. A., … Feemster, L. C. (2019). Reducing Chronic Obstructive Pulmonary Disease Hospital Readmissions. An Official American Thoracic Society Workshop Report. Annals of the American Thoracic Society, 16(2), 161–170. https://doi.org/10.1513/AnnalsATS.201811-755WS
• Singh, D., Agusti, A., Anzueto, A., Barnes, P. J., Bourbeau, J., Celli, B. R., … Vogelmeier, C. (2019). Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease: The GOLD science committee report 2019. The European Respiratory Journal, 53(5). https://doi.org/10.1183/13993003.00164-2019
• Wedzicha, J. A., Calverley, P. M. A., Albert, R. K., Anzueto, A., Criner, G. J., Hurst, J. R., … Krishnan, J. A. (2017). Prevention of COPD exacerbations: A European Respiratory Society/American Thoracic Society guideline. The European Respiratory Journal, 50(3). https://doi.org/10.1183/13993003.02265-2016