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Review
. 2018 Jun 6;27(148):180027.
doi: 10.1183/16000617.0027-2018. Print 2018 Jun 30.

COPD stands for complex obstructive pulmonary disease

Sarah Houben-Wilke #  1 , Ingrid M Augustin #  2 , Jan H Vercoulen  3 , Dirk van Ranst  4 , Eline Bij de Vaate  5 , Johan B Wempe  6 , Martijn A Spruit  2   7 , Emiel F M Wouters  2   7 , Frits M E Franssen  2   7
Affiliations
Review

COPD stands for complex obstructive pulmonary disease

Sarah Houben-Wilke et al. Eur Respir Rev. .

Abstract

Chronic obstructive pulmonary disease (COPD) has extensively been reported as a complex disease affecting patients' health beyond the lungs with a variety of intra- and extrapulmonary components and considerable variability between individuals. This review discusses the assessment of this complexity and underlines the importance of transdisciplinary management programmes addressing the physical, emotional and social health of the individual patient.COPD management is challenging and requires advanced, sophisticated strategies meeting the patient's individual needs. Due to the heterogeneity and complexity of the disease leading to non-linear and consequently poorly predictable treatment responses, multidimensional patient profiling is crucial to identify the right COPD patient for the right treatment. Current methods are often restricted to general, well-known and commonly used assessments neglecting potentially relevant (interactions between) individual, unique "traits" to finally ensure personalised treatment. Dynamic, personalised and holistic approaches are needed to tackle this multifaceted disease and to ensure personalised medicine and value-based healthcare.

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Conflict of interest statement

Conflict of interest: M.A. Spruit reports personal fees from AstraZeneca, Boehringer Ingelheim, GSK and Novartis, outside the submitted work. Conflict of interest: E.F.M Wouters has received fees for board membership from Nycomed and Boehringer, and has received grants from AstraZeneca and GSK. He has also received payment for lectures (including service on speakers bureaus) from AstraZeneca, GSK, Novartis and Chiesi. Conflict of interest: F.M.E. Franssen reports personal fees from AstraZeneca, Chiesi, Novartis, Boehringer Ingelheim, GlaxoSmithKline and TEVA, outside the submitted work.

Figures

FIGURE 1
FIGURE 1
Examples of personal barriers and enablers that both encourage and limit participation in physical activity for patients with chronic obstructive pulmonary disease (COPD). PA: physical activity. Reproduced from [53] with permission.
FIGURE 2
FIGURE 2
The process of a patient-tailored programme including the three core processes (baseline assessment, tailored treatment and outcome assessment). An integrated baseline assessment identifying the complexity of the disease is followed by a treatment programme composed of at least all basic modules. Depending on the complexity, specific burden-driven modules can be added. Each individualised programme is followed by an outcome measurement. Examples of adaptations include degree of self-management and coping. Reproduced from [21] with permission.
See this image and copyright information in PMC

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