Chronic Obstructive Pulmonary Disease (COPD)

This review is a pragmatic attempt to highlight recent research and some background reading on COPD. It should not be considered exhaustive, simply a way of reviewing some of the major developments and current thinking in the area.

Click here to see all the TRIP Evidence Reviews

Evidence-Based Reports

• Procalcitonin test can reduce antibiotic use in COPD. POEMs, 2007
• Triple therapy in COPD. Northern and Yorkshire Drug and Therapeutics Centre, 2007
• The management of chronic obstructive pulmonary disease (COPD). MeReC, 2006
• Managing COPD and preventing progression. National Prescribing Service Limited, 2006
• Oral Mucolytics In COPD. Northern and Yorkshire Drug and Therapeutics Centre, 2005
• Review: tiotropium reduces exacerbations and hospital admissions in COPD and improves quality of life. Evidence-Based Medicine (Requires free registration), 2006

Clinical Guidelines

• Management of chronic obstructive pulmonary disease in adults in primary and secondary care. NICE, 2004
• Chronic obstructive pulmonary disease. PRODIGY, 2006
• Chronic obstructive pulmonary disease (COPD). British Columbia Ministry of Health, 2005
• Chronic obstructive pulmonary disease (COPD). Finnish Medical Society Duodecim, 2005
• The COPD-X Plan: Australian and New Zealand Guidelines for the management of Chronic Obstructive Pulmonary Disease. New Zealand Guidelines Group, 2006

Systematic Reviews

• Long-acting Beta2-agonists (LABA) plus corticosteroids versus LABA alone for chronic obstructive pulmonary disease. Health Technology Assessment, 2007
• Influenza vaccine for patients with chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews, 2005
• Long-acting beta2-agonists for poorly reversible chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews, 2006
• Antibiotics for exacerbations of chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews, 2006
• Mucolytic agents for chronic bronchitis or chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews, 2006
• Ipratropium bromide versus short acting beta-2 agonists for stable chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews, 2006
• Ipratropium bromide versus long-acting beta-2 agonists for stable chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews, 2006
• Oxygen therapy in the pre-hospital setting for acute exacerbations of chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews, 2006
• Pulmonary rehabilitation for chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews, 2006

Recent articles in core journals

• Chronic Obstructive Pulmonary Disease: Diagnostic Considerations. American Family Physician, 2006
• Antibiotic Treatment of Exacerbations of COPD: A Randomized, Controlled Trial Comparing Procalcitonin-Guidance With Standard Therapy. Chest, 2007
• Meta-analysis: anticholinergics, but not beta-agonists, reduce severe exacerbations and respiratory mortality in COPD. J Gen Intern Med, 2006
• Economic Benefits of Self-Management Education in COPD. Chest, 2006
• Tiotropium in Combination with Placebo, Salmeterol, or Fluticasone-Salmeterol for Treatment of Chronic Obstructive Pulmonary Disease: A Randomized Trial. Annals of Internal Medicine, 2007
• Invariant natural killer T cells in asthma and chronic obstructive pulmonary disease. NEJM, 2007
• Salmeterol and fluticasone propionate and survival in chronic obstructive pulmonary disease. NEJM, 2007
• Quality of care for patients hospitalized for acute exacerbations of chronic obstructive pulmonary disease. Annals of Internal Medicine, 2006

eTextbooks

• eMedicine
• Ganfyd
• Merck Manual
• GP Notebook

Clinical Queries

• What is the evidence regarding the benefit of long term oxygen therapy in COPD? Is there any evidence which says that 16 hours oxygen per day is better than 12 hours per day? ATTRACT, 2007
• I know that the guidelines recommend Spirometry for monitoring COPD. How do the results of the spirometry influence management? NLH Q&A Service, 2007
• Is there any guidance on the discontinuation of steroids after prolonged courses in COPD and asthma, i.e. how to reduce them and over what length of time? ATTRACT, 2007
• In respiratory patients (eg COPD) treated with intermittent high dose oral steroids,when should we consider prophylaxis for osteoporosis using bisphosphonates? NLH Q&A Service, 2007
• Anxiety and panic attacks are common in people who suffer severe COPD is there any guidelines/evidence on the most effective management of anxiety/panic in these patients? NLH Q&A Service, 2006

Patient Information

• Medline Plus
• NHS Direct Online
• eMedicine Consumer Health
• BUPA Health Information