COPD is a complex disease and a cause of significant morbidity and mortality. It requires interprofessional care and the involvement of more than one subspecialties. This patient-centered approach involving a physician with a team of other health professionals, physiotherapists, respiratory therapists, dieticians, social workers, clinical psychologists, nurses, and support groups working together for the patient plays an important role in improving the quality of care in COPD patients. It not only decreases the hospital admission rates but also positively affect the disease outcome.

The family physician, based on the symptoms and smoking history, orders spirometry for determining the diagnosis and assessing the severity of the disease. The comorbidities and infections are a common cause of worsening COPD and COPD exacerbation. Therefore, the proper monitoring and management of COPD and the comorbidities are equally important in improving the survival of COPD patients. The patients with severe disease who experience exacerbations are managed in respiratory unit ICU. COPD exacerbation in patients with kidney disease needs to be treated in ICU where he/she can be taken care of by the different subspecialty physicians. On discharge, the collaboration between the hospital physicians and the family physician ensures the continuous care of the patient.

The complex management of COPD involves patient education, self-management, and pulmonary rehabilitation in addition to the above. Physicians and respiratory therapists assist with patient education, which primarily includes behavior/lifestyle modification, for example, smoking cessation, education about symptoms of COPD exacerbation, the importance of regular medications, and the proper use of prescribed medications. Self-management plan includes taking medications regularly, awareness of severe symptoms, and learning to live with their disease. Pulmonary rehabilitation is also an important intervention which not only improves dyspnea and exercises tolerance but also substantially reduces hospital admission rates. A physiotherapist can assist in pulmonary rehabilitation programs to help with exercise and overall conditioning. The nurse can assist with patient monitoring, education, and coordination of follow-up care. The pharmacist can help avoid drug-drug interactions and make recommendations in regards to appropriate therapy and dosing. Dieticians can assist patients who are overweight or underweight. Family physicians play an important role in discussing end-of-life and palliative care with the patients.

The communication between the team members taking care of the patient and regular assessment of the patient’s condition helps maximize the respiratory potential of the patient and, hence cost-effectively decreases the disease burden.[23] [Level V]

This is a portion of a report produced by the National Institute of Health (NIH) concerning the best practice for patient care.https://www.nih.gov/