Skip to main content

Advertisement

Table 1 Planning COPD monitoring

From: The clinical and integrated management of COPD. An official document of AIMAR (Interdisciplinary Association for Research in Lung Disease), AIPO (Italian Association of Hospital Pulmonologists), SIMER (Italian Society of Respiratory Medicine), SIMG (Italian Society of General Medicine)

Planned actions Monitoring chronic bronchitis (without flow limitation) or mild COPD (FEV1/CV < LLN and FEV1 > 80%) without symptoms Monitoring COPD with FEV1 < 80% and/or exercise dyspnea and/or comorbidities Monitoring COPD with FEV1 < 60% and/or exercise dyspnea and/or frequent exacerbations and/or comorbidities Monitoring COPD with FEV1 < 50% with respiratory insufficiency and comorbidity**
Timing Every other year Every year Every year Every year
Smoking cessation, if a smoker Every physician/nurse or smoking cessation clinic Every physician/nurse or smoking cessation clinic Every physician/nurse or smoking cessation clinic Every physician/nurse or smoking cessation clinic
Clinical check (including Body Mass Index, questionnaires and assessment of risk factors) Chest physicians and general practitioner Chest physicians and general practitioner Chest physicians and general practitioner Chest physicians and general practitioner
Pulsoximetry Chest physicians and general practitioner Chest physicians and general practitioner Chest physicians and general practitioner Chest physicians and general practitioner
Flow-volume curve Chest physicians and general practitioner Chest physicians and general practitioner Chest physicians and general practitioner Chest physicians and general practitioner
Chest physician consultation Chest physician Chest physician Chest physician Chest physician
Full spirometry Respiratory function unit* Respiratory function unit Respiratory function unit Respiratory function unit
Diffusion test (DLCO)   Respiratory function unit* Respiratory function unit* Respiratory function unit
Chest-X-ray* Radiology Radiology Radiology Radiology
EKG* Chest physicians and general practitioner Chest physicians and general practitioner Chest physicians and general practitioner Chest physicians and general practitioner
EKG cardiac ultrasound   Specialized unit Specialized unit Specialized unit
Blood gas analysis (BGA)    Respiratory function unit Respiratory function unit
6-min walking test   Respiratory function unit Respiratory function unit Respiratory function unit
Nocturnal pulsoximetry*   Respiratory function unit Respiratory function unit Respiratory function unit
Other consultation and/or tests*   Other consultation and/ or tests* Other consultation and/ or tests* Other consultation and/ or tests*
   General practitioners are in charge of chronic treatment monitoring: Every six months he/she checks the clinical situation in own clinic. He/she carries out a pulsoximetry at each exacerbation and the following 2 months. Refers the patient to a consultation in case of persistent worsening General practitioners are in charge of chronic treatment monitoring: Every three months he/she checks the clinical situation in own clinic. Refers the patient to a consultation in case of exacerbation. Chest physician has in charge the patient until the recovery of the steady state General practitioners are in charge of chronic treatment monitoring. Every two months he/she checks the clinical situation in own clinic. Quickly refers the patient to a consultation in case of exacerbation or complaint of new symptoms/signs. Chest physician has in charge the patient until the recovery of the steady state and monitors the comorbidities, using the proper referrals
  1. (*) when needed (**) patient in OLTT deserves BGA and clinical check at least every six-month.