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“EPOC FACIL”, the new primary intervention manual

EASY COPD is a primary intervention manual that aims to respond to a socio-health challenge: the approach to Chronic Obstructive Pulmonary Disease (COPD), a complex and heterogeneous respiratory pathology.

COPD EASY, the new primary intervention manual

Image provided by SEMERGEN

SEMERGEN Madrid launches this document which summarizes in eight points the agile, efficient and easy way to tackle COPD, highlighting the most relevant issues of this pathology, such as the procedures to be followed or the treatment.

This intervention manual, prepared by seven family doctors, specialized in pathology, and a pulmonologist has had the collaboration of the pharmaceutical company AstraZeneca.

At EFEsalut we spoke with Raúl de Simón, secretary of SEMERGEN Madrid, to find out more about the importance of this simplification of procedures.

COPD EASY: eight areas to address

COPD, defined as a chronic respiratory disease that progresses progressively and limits the quality of life of those who suffer from it, is a pathology closely linked to smoking.

present symptoms as common as the Cough and the expectorationalthough to this is added the progressive respiratory distress. Unfortunately, they are often underestimated, making it necessary to formalize a guide that easily covers COPD.

The points on which this guide is based are:

  • Diagnosis and evaluation of COPD. The main idea is that COPD should be suspected in any adult patient who smokes or ex-smokes more than 10 packs a year or has a history of chronic exposure to inhaled toxins
  • Pharmacological treatment. It is important, in this case, to follow clinical practice guidelines, in addition to considering that treatable traits require specific treatment in addition to the general one.
  • Non-pharmacological treatment. Smoking cessation, influenza vaccination, physical activity, an adapted diet, the use of daytime and/or nighttime respiratory support if necessary and specific home respiratory physiotherapy should be recommended to all patients.
  • Exacerbations. It is important to consider exacerbations or flares as a key prognostic factor, as the risk of mortality increases significantly in patients who have 2 or more exacerbations per year requiring hospitalization.
  • Inhalation device. The choice of inhalation device must be personalized. It is important that the patient knows how to handle it and that it is easy.
  • Control. It is crucial that the COPD patient has good therapeutic adherence, controls his comorbidities and does adequate physical activity.
  • Comorbidities. They have a negative impact on the prognosis of COPD and condition its treatment many times.
  • Coordination with Specialized Care. In case of doubt regarding the diagnosis, follow-up or treatment, the patient must be referred to a pulmonologist.
Presentation of the “EPOC FACIL” manual Image provided by SEMERGEN

Why is this simplification necessary?

The secretary of SEMERGEN, Raúl de Simón, explains the usefulness of the manual and insists on the concept of rapid attention.

“In primary care, training is very heterogeneous and asymmetrical, which is why making an easily applicable guide is essential. Depth in knowledge has been sacrificed to make up for it with utility,” he points out.

Therefore, the development of a guide that is quickly applicable, suitable for everyone and available to anyone is a great advantage.

But that’s not all: the lack of attention to this pathology is not solely due to generic training in Primary Care.

“The working conditions of the professionals make it difficult to take care of COPD: they are complex patients or cases, many of them are advanced in age,” says de Simón.

And time is crucial and, in this sense, the diagnosis must be the result of a follow-up. It is clear that the management of the care level in Primary Care makes this impossible.

Is it an underdiagnosed pathology?

COPD is a highly prevalent disease: according to Spanish epidemiological studies, it affects 11% of the population. And over time it has been feminized and rejuvenated, precisely because of tobacco consumption.

Moreover, according to data provided by the Spanish Society of Internal Medicine (SEMI), it is estimated that in Spain there are more than 500,000 women who, despite having COPD, have not been diagnosed.

The point is that, despite these figures, there is a 75% underdiagnosis.

Raúl de Simón indicates that it is something so common because it tends to relativize the symptoms. They are so unspecific which is not strange. Of course, he warns that, in the face of any indication of a persistent respiratory problem, a professional should be consulted.

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