FIRS The Global Impact of Respiratory Disease – Second Edition | Page 14

Along with removal of respiratory irritants or
triggers and early treatment of respiratory
infections, inhaled bronchodilators are the
basic medicines that help these patients.
Treatment with long-acting bronchodilators,
together with inhaled corticosteroids and other
pharmacological and non-pharmacological
agents, can help patients with frequent
exacerbations and severe airfl ow obstruction.
Patients with low blood oxygen levels may
require supplemental oxygen. Long-term
oxygen therapy can increase survival and
improve the quality of life in patients with very
low oxygen levels. Maintaining physical fi tness
and activity is important because diffi culty
breathing may lead to a decreased activity
and subsequent deconditioning. Therefore,
exercise-based pulmonary rehabilitation is
important for many people with COPD [21].
Treating coexisting illnesses can extend the
life of many people.
Clinical strategies are available that outline
the appropriate management of people with
COPD [22]. Despite the availability of clinical
practice guidelines, several studies have
shown that COPD is undertreated in its early
as well as advanced stages.
Control and elimination
The key element of reducing and controlling
COPD is abolishing tobacco use. This is best
addressed through political and public health
initiatives. Public health and societal efforts are
needed to reduce indoor smoke exposure and
other COPD risk factors, and to develop cost-
effective management protocols for COPD,
especially in low-income settings. Age-specifi c
mortality rates from COPD are now declining,
but the ageing world population makes this a
huge problem for decades to come. Research
should lead to better understanding of how
risk factors and comorbidities interact to affect
the severity of disease, and which other factors
cause COPD in smokers and non-smokers.
Other important research questions include
how best to identify and treat mild COPD,
and how to manage COPD in the context
of concomitant conditions, such as sleep
apnoea, cardiovascular disease, depression,
osteoporosis, diabetes, lung cancer, ageing
and frailty. This research is needed to build
management plans on a sound knowledge
base.
Forum of International Respiratory Societies
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