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** |
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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 |