Comprehensive management of patients with chronic obstructive pulmonary disease

ABSTRACT

Mortality and morbidity associated with chronic obstructive pulmonary disease [COPD] is rising in developing as well as developed countries. Rapid urbanisation and spreading network of roads and no measure to control pollution is a matter of concern for a developing country like Pakistan. Additive adverse effect of smoking is universal. It is unfortunate that despite better understanding of functional alternation in chronic obstructive pulmonary disease the care of many patients remain suboptimal. At present all our resources are directed towards treatment of established disease which is largely irreversible. Today, goal of therapy could be to improve pulmonary functions and make life as comfortable as possible. Timely advice regarding exercise training programme, occupational rehabilitation and giving up smoking may be given. Cessation of smoking while recognising and avoiding other risk factors can slow down the decline in lung function and progress of the disease. The ultimate aim is to gain maximum function within the limits of the disease and promote comfort for the patient1 rather than prolonged survival or improved lung function testing. Such a goal can be achieved, only through a comprehensive management approach: