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COPD Exacerbation Prevention
Aka: COPD Exacerbation Prevention, COPD Tertiary Prevention
- See Also
- COPD Management
- Medications in COPD Management
- Acute Exacerbation of Chronic Bronchitis
- Antibiotic Use in COPD Exacerbation
- COPD
- Chronic Bronchitis
- Emphysema
- Alpha-1-Antitrypsin Deficiency
- COPD Staging
- COPD Action Plan
- Prevention: General
- Evaluate and Manage comorbidity
- Cardiovascular disease is a top cause of mortality in COPD patients
- Immunizations for smokers or COPD aged 19 to 64 years old
- Annual Influenza Vaccine
- Wongsurakiat (2004) Chest 125:2011-20 [PubMed]
- Pneumococcal Vaccine (Pneumovax) one dose
- At age 65 years old, repeat Pneumovax as well as Prevnar (1 year apart)
- Body habitus
- Overweight "Blue boater": Attempt weight loss
- Thin "Pink Puffer": Nutritional Supplementation
- Prevent hospital admissions
- See GOLD Criteria and stepped approach below
- See COPD Action Plan
- Prevention: Tobacco Cessation
- See Tobacco Cessation
- Tobacco Cessation is the single most important intervention
- Coughing stops in 77% of those quitting smoking
- Cough improves in 17%
- Cough may stop within 4 weeks of quitting (54%)
- Quitting decreases all cause mortality >15 years
- Quitting smoking alters the decline in lung function (decreases FEV1 decline)
- Make use of Smoking Cessation adjuncts (Bupropion, Varenicline, Nicotine Replacement)
- Educating patients about their lung age (estimated via Spirometry) is effective motivation
- Parkes (2008) BMJ 336(7644): 598-600 [PubMed]
- Prevention: Pulmonary Rehabilitation
- See Pulmonary Rehabilitation
- Indicated in moderate to severe COPD with Dyspnea-limited activities or impaired quality of life
- Includes Pulmonary Rehabilitation Exercise, nutritional counseling, education and behavioral modification
- Reduces Dyspnea, improves Exercise ability and improves quality of life if continued for at least 6 months
- Salman (2003) J Gen Intern Med 18(3): 213-21 [PubMed]
- References
- Gentry (2017) Am Fam Physician 95(7): 433-41 [PubMed]