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. 2022 Dec 2;12(12):1997.
doi: 10.3390/jpm12121997.

Greek Guidelines for the Management of COPD, a Proposal of a Holistic Approach Based on the needs of the Greek Community

Nikolaos Tzanakis  1 , Epameinontas Kosmas  2 , Andriana I Papaioannou  3 , Georgios Hillas  4 , Eleftherios Zervas  5 , Stelios Loukides  3 , Petros Bakakos  6 , Paraskevi Katsaounou  7 , Afroditi Boutou  8 , Photis Perlikos  7 , Nikolleta Rovina  6 , Katerina Dimakou  4 , Paschalis Steiropoulos  9 , Grigorios Stratakos  6 , Philipos Emmanouil  6 , Stavros Tryfon  8 , Nikolaos Koulouris  6
Affiliations

Greek Guidelines for the Management of COPD, a Proposal of a Holistic Approach Based on the needs of the Greek Community

Nikolaos Tzanakis et al. J Pers Med. .

Abstract

Despite that COPD remains one of the most common respiratory diseases worldwide, it can be managed effectively with certain treatments and, more importantly, be prevented by the early implementation of various measures. The pathology and pathophysiology of this disease continue to be studied, with new pharmacological and invasive therapies emerging. In this consensus paper, the Working Group of the Hellenic Thoracic Society aimed to consolidate the up-to-date information and new advances in the treatment of COPD. Local and international data on its prevalence are presented, with revised strategies on the diagnostic approach and the evaluation of risk assessment and disease severity classification. Emphasis is placed on the management and therapy of patients with COPD, covering both common principles, specialized modalities, and algorithms to distinguish between home care and the need for hospitalization. Although pharmacological treatment is commonly recognized in COPD, an integrative approach of pulmonary rehabilitation, physical activity, patient education, and self-assessment should be encountered for a comprehensive treatment, prevention of exacerbations, and increased quality of life in patients.

Keywords: COPD; Greece; guidelines; management.

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Conflict of interest statement

P. Emmanouil, N. Koulouris, S. Tryfon, and F. Perlikos have nothing to disclose. P. Bakakos has received fees for advisory boards from AstraZeneca, GSK, Menarini, and ELPEN and honoraria from GSK, Astra Zeneca, Chiesi, Elpen, Novartis, and Boheringer Ingelheim. A. Boutou has received a research grant from the Hellenic Thoracic Society, honoraria from Menarini Hellas, Elpen, and Chiesi Hellas, and support for attending meetings from Chiesi Hellas, Menarini Hellas, Elpen, Actelion Hellas, and Boehringer Ingelheim. K. Dimakou has received consulting fees and honoraria from Chiesi, AstraZeneca, Boerhinger Ingelheim, GSK, Pfizer, Menarini, and Novartis. G. Hillas has received consulting fees from AstraZeneca, Novartis, Boehringer Ingelheim, GSK, Chiesi, Menarini, ELPEN, Pharmathen, Specialty Therapeutics and Sanofi, honoraria from AstraZeneca, Boehringer Ingelheim, CHIESI, CSL Behring, ELPEN, Innovis, GSK, Menarini, Novartis, Pharmathen, Sanofi, Specialty Therapeutics, and UCB, and support for attending meetings from AstraZeneca, Novartis, Boehringer Ingelheim, Chiesi, GSK, Menarini, Innovis, and Elpen. P. Katasounou has received financial support for travelling and congress from Chiesi, Boehringer Ingelheim, AstraZeneca, Novartis, and Pfizer. E. Kosmas has received grants, consulting fees, honoraria, and support for attending meetings from AstraZeneca, Boehringer Ingelheim, Chiesi, CSL Behring, Elpen, GSK, Menarini, Novartis, and Vianex. S. Loukides has received honoraria from Elpen, AstraZeneca, GSK, Chiesi, Sanofi, Boehringer Ingelheim, and Menarini. A. Papaioannou has received consulting fees from AstraZeneca, Novartis, Boehringer Ingelheim, and Chiesi, honoraria for presentations from AstraZeneca Novartis, Boehringer Ingelheim, Chiesi, Menarini, and Elpen, and support for attending meetings from AstraZeneca Novartis, Boehringer Ingelheim, Chiesi, Menarini, and ELPEN. N. Rovina has received honoraria from Astra Zeneca, Chiesi, and Menarini and support for attending meetings from Chiesi and Menarini. P. Steiropoulos has received consulting fees, honoraria, and support for attending meetings from AstraZeneca, Boehringer Ingelheim, Elpen, GSK, Menarini, and Novartis. G. Stratakos has received honoraria from AstraZeneca and Behring, support for attending meetings from Chiesi and Behring, and participation in advisory boards for AstraZeneca and Behring. N. Tzanakis has received consulting fees and honoraria from GSK, Novartis, AstraZeneca, Elpen, Pharmathen, Chiesi, Takeda, Pfizer, Bayer, UCB, Nycomed, Vianex, Help, Takeda, and Boehringer Ingelheim and support for attending meetings from GSK, Boehringer Ingelheim, Novartis, AstraZeneca, Elpen, Pharmaten, Chiesi, Takeda, and UCB. E. Zervas has received honoraria from AstraZeneca, Novartis, Menarini, Chiesi, and Elpen, support for attending meetings from AstraZeneca, Boehringer Ingelheim, Novartis, Menarini, Chiesi, and Elpen, and participation in advisory boards from AstraZeneca, GSK, Menarini, Chiesi, and Elpen.

Figures

Figure 1
Figure 1
Steps in the treatment of COPD. Abbreviation: COPD, chronic obstructive pulmonary disease. 1 Evaluate comorbidities carefully. 2 Use the Lower Limit of Norma, (LLN) in borderline values especially in patients bellow 45 and over 80 years of age.
Figure 2
Figure 2
(a) Classification of prognostic risk. Footnote: 1 Carefully evaluate comorbidities. 2 Use LLNs in patients with borderline values, especially in patients <45 and >80 years of age. Abbreviation: LLN, lower limit of normal. (b) Treatment algorithm for stable COPD. Abbreviation: COPD, chronic pulmonary disease.
Figure 2
Figure 2
(a) Classification of prognostic risk. Footnote: 1 Carefully evaluate comorbidities. 2 Use LLNs in patients with borderline values, especially in patients <45 and >80 years of age. Abbreviation: LLN, lower limit of normal. (b) Treatment algorithm for stable COPD. Abbreviation: COPD, chronic pulmonary disease.
Figure 3
Figure 3
Home management of a COPD exacerbation. Abbreviation: COPD, chronic pulmonary disease.
See this image and copyright information in PMC

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