Chest
Evidence-Based MedicinePrevention of Acute Exacerbations of COPD: American College of Chest Physicians and Canadian Thoracic Society Guideline
Section snippets
PICO 1: Do Nonpharmacologic Treatments and Vaccinations Prevent/Decrease Acute Exacerbations of COPD?
1. In patients with COPD, we suggest administering the 23-valent pneumococcal vaccine as part of overall medical management but did not find sufficient evidence that pneumococcal vaccination prevents acute exacerbations of COPD(Grade 2C).
Expert Panel Composition
Members from CHEST and CTS were selected to participate on the AECOPD Guideline panel based on their expertise in the field. CTS representatives were members of the CTS COPD Clinical Assembly. Members who were interested in serving on the guideline panel were asked to submit their curriculum vitae, statement of interest, and conflict of interest disclosure form to the CHEST GOC for review. The final panel comprised a chair from CHEST and vice-chair from CTS as well as eight panelists from CHEST
PICO 1: Do Nonpharmacologic Treatments and Vaccinations Prevent/Decrease Acute Exacerbations of COPD?
Effective support and management of individuals at risk for an AECOPD demands a comprehensive and patient-centered approach. The widely adopted Chronic Care Model34, 35 recognizes that improvements in care require approaches incorporating patient-, provider-, and system-level interventions. Key elements of the Chronic Care Model are the health system, delivery system design (including case management), decision support, clinical information systems, self-management support (including
Conclusions
These guidelines provide the clinician with evidence-based information on therapies to prevent COPD exacerbations using an objective, rigorous, evidence-based approach to the assessment of the existing literature regarding nonpharmacologic inhaled and oral therapies (Fig 1). We have avoided providing opinions, instead using objective assessment of each recommendation where the data are robust enough to provide a meaningful conclusion based on the available data. This assessment also highlights
Acknowledgments
Author contributions:G. J. C. is the guarantor of the manuscript. G. J. C. drafted recommendations and supporting text for the Inhaled Therapies section and Introduction, oversaw the drafting of the Inhaled Therapies section and the entire manuscript, and synthesized all of the sections in the final manuscript and executive summary; J. B. oversaw the drafting of the Oral Therapies section and drafted supporting text for the section, advised the nonpharmacologic therapies writing committee, and
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