Tips en enfermedad pulmonar obstructiva crónica: recomendaciones en el manejo de corticoides inhalados

Abstract

Introduction. In recent years, many advances have been made related with chronic obstructive pulmonary disease (COPD), and above all frequent changes have taken place in the recommendations regarding its treatment, specifically on the indication and use of inhaled corticosteroids (IC). Objectives. This document aims to generate updated recommendations on the use of ICs in order to optimize the treatment of patients who come to the medical office of the primary care professionals. Materials and methods. Pneumologists and primary care (PC) physicians have participated in this project in all of the national territory, sharing clinical experiences in order to gather information on the situation of the management of ICs in patients with COPD in each region, analyzing and validating the recommendations previously elaborated by the Scientific Committee after a comprehensive review of the existing scientific evidence. Results. The majority of the participants expressed their approval with the recommendations. Training should be increased on concepts such as exacerbation of the disease and safety of the ICs. It is important to tailor the treatments and decrease the variability of criteria. The number of regular reviews needs to be increased as well as the need to update the treatment protocols and to place emphasis on the recommendations of the clinical practice guidelines on the LABA/IC treatment patients with asthma-COPD overlaping1-4 or with elevated eosinophil count. Involvement of all the health care professionals participating in the treatment of the patients with COPD should be encouraged and more economic resources must be invested in the health care education of the patients. Conclusions. A series of validated, discussed and agreed upon recommendations by the PC physicians are proposed in this project in relationship with the correct identification of patients with COPD who are candidates for treatment with inhaled ICs (exacerbator or ACO patients) and the safety of the use of these, which we hope will be of help in the decision making of the health care professionals.