Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Feb 12:16:289-299.
doi: 10.2147/COPD.S222664. eCollection 2021.

GOLD in Practice: Chronic Obstructive Pulmonary Disease Treatment and Management in the Primary Care Setting

Barbara P Yawn  1   2 , Matthew L Mintz  3 , Dennis E Doherty  4
Affiliations
Review

GOLD in Practice: Chronic Obstructive Pulmonary Disease Treatment and Management in the Primary Care Setting

Barbara P Yawn et al. Int J Chron Obstruct Pulmon Dis. .

Abstract

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality. Early detection and appropriate treatment and management of COPD can lower morbidity and perhaps mortality. Clinicians in the primary care setting provide the majority of COPD care and are pivotal in the diagnosis and management of COPD. In this review, we provide an overview of the Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2020 report, with a focus on the management of COPD in the primary care setting. We discuss the pathophysiology of COPD; describe COPD risk factors, signs, and symptoms that may facilitate earlier diagnosis of COPD; and reinforce the importance of spirometry use in establishing the diagnosis of COPD. Disease monitoring, as well as a review of the 2020 GOLD treatment recommendations, is also discussed. Patients and families are important partners in COPD management; therefore, we outline simple steps that may assist them in caring for those affected by COPD. Finally, we discuss nonpharmacological treatment options for COPD, COPD monitoring tools that may aid in the evaluation of disease progression and response to therapy, and the importance of developing a COPD action plan on an individualized basis.

Keywords: COPD; LABA; LAMA; primary care.

PubMed Disclaimer

Conflict of interest statement

BPY served on advisory boards for Boehringer Ingelheim, AstraZeneca, TEVA, and GlaxoSmithKline (GSK) and received consulting fees from GSK related to COPD; and received grants from the COPD Foundation, Boehringer Ingelheim, and National Heart, Lung, and Blood Institute (NHLBI), outside the submitted work. MLM received speaking and consulting fees from GSK, Mylan, and Boehringer Ingelheim, outside the submitted work. DED served on advisory boards and received speaker fees from AstraZeneca and Boehringer Ingelheim and received grants from Boehringer Ingelheim and NHLBI outside of the submitted work. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Pathophysiology of chronic obstructive pulmonary disease. During the time course of COPD, inflammation of the airways can lead to thickening of the airway walls, increased mucus production, and damage to alveoli and alveolar ducts that leads to enlargement of the air spaces/emphysema, and potentially to air-trapping.
Figure 2
Figure 2
Diagnosis, assessment, initial, and follow-up treatment of COPD.
Figure 3
Figure 3
Nonpharmacological management of COPD at diagnosis and follow-up.
Figure 4
Figure 4
Effects of smoking on COPD risk and lung age.
See this image and copyright information in PMC

References

    1. Viegi G, Maio S, Fasola S, Baldacci S. Global burden of chronic respiratory diseases. J Aerosol Med Pulm Drug Deliv. 2020;33(4):171–177. doi: 10.1089/jamp.2019.1576 - DOI - PubMed
    1. Murphy SL, Xu J, Kochanek KD, Arias E. Mortality in the United States, 2017. NCHS Data Brief. 2018;(328):1–8. - PubMed
    1. Centers for Disease Control and Prevention. COPD death rates in the United States. Available from: https://www.cdc.gov/copd/data.html. Accessed October26, 2020.
    1. Vorrink SN, Kort HS, Troosters T, Lammers JW. Level of daily physical activity in individuals with COPD compared with healthy controls. Respir Res. 2011;12(1):33. doi: 10.1186/1465-9921-12-33 - DOI - PMC - PubMed
    1. Global Initiative for Chronic Obstructive Lung Disease. Global strategy for prevention, diagnosis, and management of chronic obstructive pulmonary disease; 2020. Available from: https://goldcopd.org. Accessed October26, 2020.

MeSH terms

Substances