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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.