Chronic Obstructive Pulmonary Disease Exacerbations: A Need for Action

Antonio Anzueto, Marc Miravitlles

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality, with exacerbations contributing strongly to the overall severity and burden of disease at the individual level. Many patients with COPD are managed predominantly in the primary care setting; therefore, primary care physicians (PCPs) must have awareness and understanding of the causes, effects, and management of exacerbations in COPD. This review offers practical information regarding how exacerbations are defined in the treatment setting, pathogenic and environmental causes, options for exacerbation treatment and prevention, and suggestions for improving care in the clinic. Exacerbations have a strong negative impact on patients and are associated with an increased risk of further exacerbations and declines in lung function. Thus, it is important that exacerbations not requiring hospitalization can be identified and confidently managed in the clinical setting. Understanding treatment options for acute exacerbations and maintenance treatment to prevent future exacerbations may help PCPs better understand what they can do within their practice to support patients. This review aims to provide useful guidance for PCPs to identify exacerbations and adjust their practice for optimal management of exacerbations in patients with COPD, and to encourage PCPs that they have an important task in integrating effective COPD management into the primary care setting.