Therapeutic strategy to prevent acute exacerbations of chronic obstructive pulmonary disease: clinical guidelines of American College of Chest Physicians and Canadian Thoracic Society Guideline (Part 2)

Abstract

Chronic obstructive pulmonary disease (COPD) is an important cause of morbidity and mortality worldwide. An acute exacerbation of COPD greatly contributes to worsening lung function, impairment in quality of life, need for urgent care, and use of medical utilities. Last decade, our understanding of the pathogenesis and treatment of COPD has significantly improved. The guideline accumulated recent information about the prevention of acute exacerbations of COPD.Methods. The American College of Chest Physicians and Canadian Thoracic Society developed evidencebased guideline to describe the current knowledge on the prevention of acute exacerbations in a clinically useful manner. The PICO approach (population, intervention, comparator, and outcome) was used which involved nonpharmacologic therapies, inhaled therapies, and oral therapies. To select the most appropriate studies, to extract evidencebased data and to grade the level of evidence, evidencebased document assessment tools were applied.Results. The guideline was designed as a systematic review and critical evaluation of the published literature by clinical experts and researchers in the field of COPD and recommendations were developed to help clinicians in their management of the patient with COPD.Conclusion. This guideline provides an uptodate, rigorous, evidencebased analysis of current randomized controlled trials on the prevention of COPD exacerbations.