COPD – Preparing Indian Guidelines

Forming Indian Guidelines for Treating COPD patients

Dr. Dheeraj Gupta

Although numerous evidence-based guidelines are available for the diagnosis and management of COPD with recent updates Globally; there are differences in the overall types of cases, risk factors, disease prevalence and health-care infrastructure in India, which makes it important to have our own guidelines for diagnosis and management of chronic obstructive pulmonary disease (COPD) in India.

The task was accomplished in a joint exercise by the Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, with sponsorship from two National Pulmonary Associations (Indian Chest Society and National College of Chest Physicians). The committee constituted for this purpose included representation of the two associations, and experts from other academic institutes, medical colleges, armed forces medical corps, state health services, corporate hospitals and practitioners.

For development of guidelines, a desk-review was followed by a joint workshop. The search was conducted under five subgroups (a) definitions, epidemiology and disease burden, (b) disease assessment and diagnosis, (c) pharmacologic management of stable COPD, (d) management of acute exacerbations, and (e) non-pharmacologic and preventive measures. Important questions were framed on the basis of discussions on issues with reference to the Indian context. Literature review and discussions in each area were coordinated by Group Chairs and recorded by a rapporteur. The available evidence as well as the questions was circulated to all the group members before the joint workshop. Discussions for grading of evidence and recommendations were held independently in five parallel group sessions, and thereafter together in the joint meeting of all the groups. Final decisions in the joint group were based on a consensus approach on the majority voting. The final document was reviewed and approved by all the committee members, as well as by other external experts.

The guidelines are freely available at the website of Lung India (Vol 30. issue 3. Jul-Sept 2013)

If a patients witness above mentioned symptoms, he must pay a visit to the physician. The physician will suspect COPD based on symptoms and history of exposure to certain risk factors. The diagnosis of COPD is then confirmed by a simple breathing test called Spirometry. In this test patients will be asked to breathe in, to hold air in the lungs and to breathe it out. This test determines health of the lungs by assessing how easily patients can perform.

The most important part of treatment is complete cessation of smoking and avoidance of other risk factors. No amount of medicine will work if you continue smoking. Also know that benefits of quitting smoking is quickly lost if you resume smoking. If ignored, COPD may lead to lung failure, heart failure and several other complications.

Dr. Dheeraj Gupta
Professor, Department of Pulmonary Medicine
[WHO Collaborating Center for Research and Capacity Building in Chronic Respiratory Diseases]
Postgraduate Institute of Medical Education and Research (PGIMER)
Chandigarh. India. 160012