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Review
. 2021 Sep 9;31(1):41.
doi: 10.1038/s41533-021-00254-8.

Targeting exertional breathlessness to improve physical activity: the role of primary care

Miguel Román-Rodríguez  1   2 , Janwillem W H Kocks  3   4   5
Affiliations
Review

Targeting exertional breathlessness to improve physical activity: the role of primary care

Miguel Román-Rodríguez et al. NPJ Prim Care Respir Med. .

Abstract

Primary care physicians (PCPs) play a crucial role in the diagnosis and management of chronic obstructive pulmonary disease (COPD). By working together with patients to target exertional breathlessness and increase physical activity, PCPs have an important role to play, early in the disease course, in improving patient outcomes in both the short and long term. In this article, we consider how physical activity affects disease progression from the PCP perspective. We discuss the role of pharmacological therapy, the importance of an holistic approach and the role of PCPs in assessing and promoting physical activity. The complexity and heterogeneity of COPD make it a challenging disease to treat. Patients' avoidance of activity, and subsequent decline in capacity to perform it, further impacts the management of the disease. Improving patient tolerance of physical activity, increasing participation in daily activities and helping patients to remain active are clear goals of COPD management. These may require an holistic approach to management, including pulmonary rehabilitation and psychological programmes in parallel with bronchodilation therapy, in order to address both physiological and behavioural factors. PCPs have an important role to optimise therapy, set goals and communicate the importance of maintaining physical activity to their patients. In addition, optimal treatment that addresses activity-related breathlessness can help prevent the downward spiral of inactivity and get patients moving again, to improve their overall health and long-term prognosis.

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Conflict of interest statement

M.R.-R. reports grants and personal fees from AstraZeneca and GSK, and personal fees from Boehringer Ingelheim, Chiesi, Menarini, Mundipharma, Novartis, Pfizer, Teva, Trudell and Bial outside the submitted work. J.W.H.K. reports grants, personal fees and non-financial support from AstraZeneca, Boehringer Ingelheim and GSK, grants and personal fees from Chiesi Pharmaceuticals and Teva, grants from Mundipharma, and personal fees from MSD and Covis Pharma outside the submitted work. He also holds 72.5% of shares in the General Practitioners Research Institute.

Figures

Fig. 1
Fig. 1. Relationship between hyperinflation and breathlessness in patients with COPD.
ERV expiratory reserve volume, FRC functional residual capacity, IC inspiratory capacity, IRV inspiratory reserve volume, RV residual volume, TLC total lung capacity, VT tidal volume.
Fig. 2
Fig. 2. Targeting exertional breathlessness to improve physical activity: the role of primary care.
COPD chronic obstructive pulmonary disease, PCP primary care physician.
See this image and copyright information in PMC

References

    1. Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease (2021 report). https://goldcopd.org/wp-content/uploads/2020/11/GOLD-REPORT-2021-v1.1-25... (2020).
    1. Troosters T, et al. Physical inactivity in patients with COPD, a controlled multi-center pilot-study. Respir. Med. 2010;104:1005–1011. doi: 10.1016/j.rmed.2010.01.012. - DOI - PMC - PubMed
    1. Yawn BP, Wollan PC. Knowledge and attitudes of family physicians coming to COPD continuing medical education. Int. J. Chronic Obstr. Pulm. Dis. 2008;3:311–317. doi: 10.2147/COPD.S2486. - DOI - PMC - PubMed
    1. Fromer L. Diagnosing and treating COPD: understanding the challenges and finding solutions. Int. J. Gen. Med. 2011;4:729–739. - PMC - PubMed
    1. Labaki WW, Han MK. Improving detection of early chronic obstructive pulmonary disease. Ann. Am. Thorac. Soc. 2018;15:S243–S248. doi: 10.1513/AnnalsATS.201808-529MG. - DOI - PMC - PubMed

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