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Topic Nomination: Treatments for Chronic Obstructive Pulmonary Disease Exacerbation

Briefly describe a specific question, or set of related questions, about a health care test or treatment that this program should consider.

Topic Nomination: Chronic Obstructive Pulmonary Disease Suggested Key Questions:

1.In adult patients who have COPD, what are the benefits and harms of pharmacologic therapies for decreasing symptoms and increasing function? 2.In adult patients who have COPD, what is the comparative accuracy and impact on clinical decision-making of available clinical and imaging tools to assess severity of symptoms? 3.In adult patients who have COPD, what are the benefits and harms of non-pharmacologic therapies for decreasing symptoms and increasing function? 4.In adult patients who have COPD, what are the benefits and harms of pharmacologic therapies for treatment of exacerbation of symptoms? 5.In adult patients who have COPD, what are the benefits and harms of non-pharmacologic therapies for treatment of exacerbation of symptoms?

Patient population = Nonpregnant adult patients who have COPD Special populations

Adult patients with comorbidities (e.g. diabetes, HTN, renal failure, CHF, obesity, CVD, depression, osteoporosis)

Describe why this topic is important.

Chronic Obstructive Pulmonary Disease (COPD) was the third leading cause of death in the U.S. in 2014 with over 15 million people reporting being diagnosed with the condition (1). This number may be higher as many people with low pulmonary function are unaware that they have COPD. Patients with COPD have increased morbidity and report a lower quality of life compared to those patients without COPD (2). Stable COPD can be well managed; however, acute exacerbations present a more difficult problem to manage. There is a lack of clear definitions for COPD exacerbations and tools for assessing symptoms are not widely used in practice. Antibiotic use in patients with COPD exacerbations also widely vary. As appropriate treatment can alleviate symptoms and decrease the frequency and severity of exacerbations in patients with COPD, a systematic review on these subjects would provide guidance for management of these patients in the primary care setting. Additionally there have been a variety of new drugs and delivery systems approved for use in COPD so a comparative effectiveness review would provide insight for recommendations of the pharmacologic agents.

How will an answer to your research question be used or help inform decisions for you or your group?

The evidence from the systematic review will be used to inform recommendations for a clinical practice guideline from AAFP.

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Medical Specialty Society
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American Academy of Family Physicians
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Page last reviewed February 2018
Page originally created May 2017

Internet Citation: Topic Nomination: Treatments for Chronic Obstructive Pulmonary Disease Exacerbation. Content last reviewed February 2018. Effective Health Care Program, Agency for Healthcare Research and Quality, Rockville, MD.
https://effectivehealthcare.ahrq.gov/get-involved/nominated-topics/topic-nomination-chronic-obstructive-pulmonary-disease-suggested-key-questions-1in-adult-patients-who-have-copd-what-are-the-benefits-and-harms-of-pharmacologic-therapies-for-decreasing-symptoms-and-increasing-function-2in-a

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