Prevention of Acute Exacerbations of COPD: American College of Chest Physicians and Canadian Thoracic Society Guideline

Gerard J. Criner, Jean Bourbeau, Rebecca L. Diekemper, Daniel R. Ouellette, Donna Goodridge, Paul Hernandez, Kristen Curren, Meyer S. Balter, Mohit Bhutani, Pat G. Camp, Bartolome R. Celli, Gail Dechman, Mark T. Dransfield, Stanley Fiel, Marilyn G. Foreman, Nicola A. Hanania, Belinda K. Ireland, Nathaniel Marchetti, Darcy D. Marciniuk, Richard A. MularskiJoseph Ornelas, Jeremy D. Road, Michael K. Stickland

Research output: Contribution to journalArticle

129 Citations (Scopus)

Abstract

BACKGROUND:COPD is a major cause of morbidity and mortality in the United States as well as throughout the rest of the world. An exacerbation of COPD (periodic escalations of symptoms of cough, dyspnea, and sputum production) is a major contributor to worsening lung function, impairment in quality of life, need for urgent care or hospitalization, and cost of care in COPD. Research conducted over the past decade has contributed much to our current understanding of the pathogenesis and treatment of COPD. Additionally, an evolving literature has accumulated about the prevention of acute exacerbations. METHODS:In recognition of the importance of preventing exacerbations in patients with COPD, the American College of Chest Physicians (CHEST) and Canadian Thoracic Society (CTS) joint evidence-based guideline (AECOPD Guideline) was developed to provide a practical, clinically useful document to describe the current state of knowledge regarding the prevention of acute exacerbations according to major categories of prevention therapies. Three key clinical questions developed using the PICO (population, intervention, comparator, and outcome) format addressed the prevention of acute exacerbations of COPD: nonpharmacologic therapies, inhaled therapies, and oral therapies. We used recognized document evaluation tools to assess and choose the most appropriate studies and to extract meaningful data and grade the level of evidence to support the recommendations in each PICO question in a balanced and unbiased fashion. RESULTS:The AECOPD Guideline is unique not only for its topic, the prevention of acute exacerbations of COPD, but also for the first-in-kind partnership between two of the largest thoracic societies in North America. The CHEST Guidelines Oversight Committee in partnership with the CTS COPD Clinical Assembly launched this project with the objective that a systematic review and critical evaluation of the published literature by clinical experts and researchers in the field of COPD would lead to a series of recommendations to assist clinicians in their management of the patient with COPD. CONCLUSIONS:This guideline is unique because it provides an up-to-date, rigorous, evidence-based analysis of current randomized controlled trial data regarding the prevention of COPD exacerbations.

Original languageEnglish (US)
Pages (from-to)894-942
Number of pages49
JournalChest
Volume147
Issue number4
DOIs
StatePublished - Apr 1 2015

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Chronic Obstructive Pulmonary Disease
Thorax
Guidelines
Therapeutics
Ambulatory Care
North America
Sputum
Cough
Dyspnea
Population
Hospitalization
Randomized Controlled Trials
Joints
Quality of Life
Research Personnel
Morbidity
Costs and Cost Analysis
Lung
Mortality

All Science Journal Classification (ASJC) codes

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Criner, G. J., Bourbeau, J., Diekemper, R. L., Ouellette, D. R., Goodridge, D., Hernandez, P., ... Stickland, M. K. (2015). Prevention of Acute Exacerbations of COPD: American College of Chest Physicians and Canadian Thoracic Society Guideline. Chest, 147(4), 894-942. https://doi.org/10.1378/chest.14-1676
Criner, Gerard J. ; Bourbeau, Jean ; Diekemper, Rebecca L. ; Ouellette, Daniel R. ; Goodridge, Donna ; Hernandez, Paul ; Curren, Kristen ; Balter, Meyer S. ; Bhutani, Mohit ; Camp, Pat G. ; Celli, Bartolome R. ; Dechman, Gail ; Dransfield, Mark T. ; Fiel, Stanley ; Foreman, Marilyn G. ; Hanania, Nicola A. ; Ireland, Belinda K. ; Marchetti, Nathaniel ; Marciniuk, Darcy D. ; Mularski, Richard A. ; Ornelas, Joseph ; Road, Jeremy D. ; Stickland, Michael K. / Prevention of Acute Exacerbations of COPD : American College of Chest Physicians and Canadian Thoracic Society Guideline. In: Chest. 2015 ; Vol. 147, No. 4. pp. 894-942.
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abstract = "BACKGROUND:COPD is a major cause of morbidity and mortality in the United States as well as throughout the rest of the world. An exacerbation of COPD (periodic escalations of symptoms of cough, dyspnea, and sputum production) is a major contributor to worsening lung function, impairment in quality of life, need for urgent care or hospitalization, and cost of care in COPD. Research conducted over the past decade has contributed much to our current understanding of the pathogenesis and treatment of COPD. Additionally, an evolving literature has accumulated about the prevention of acute exacerbations. METHODS:In recognition of the importance of preventing exacerbations in patients with COPD, the American College of Chest Physicians (CHEST) and Canadian Thoracic Society (CTS) joint evidence-based guideline (AECOPD Guideline) was developed to provide a practical, clinically useful document to describe the current state of knowledge regarding the prevention of acute exacerbations according to major categories of prevention therapies. Three key clinical questions developed using the PICO (population, intervention, comparator, and outcome) format addressed the prevention of acute exacerbations of COPD: nonpharmacologic therapies, inhaled therapies, and oral therapies. We used recognized document evaluation tools to assess and choose the most appropriate studies and to extract meaningful data and grade the level of evidence to support the recommendations in each PICO question in a balanced and unbiased fashion. RESULTS:The AECOPD Guideline is unique not only for its topic, the prevention of acute exacerbations of COPD, but also for the first-in-kind partnership between two of the largest thoracic societies in North America. The CHEST Guidelines Oversight Committee in partnership with the CTS COPD Clinical Assembly launched this project with the objective that a systematic review and critical evaluation of the published literature by clinical experts and researchers in the field of COPD would lead to a series of recommendations to assist clinicians in their management of the patient with COPD. CONCLUSIONS:This guideline is unique because it provides an up-to-date, rigorous, evidence-based analysis of current randomized controlled trial data regarding the prevention of COPD exacerbations.",
author = "Criner, {Gerard J.} and Jean Bourbeau and Diekemper, {Rebecca L.} and Ouellette, {Daniel R.} and Donna Goodridge and Paul Hernandez and Kristen Curren and Balter, {Meyer S.} and Mohit Bhutani and Camp, {Pat G.} and Celli, {Bartolome R.} and Gail Dechman and Dransfield, {Mark T.} and Stanley Fiel and Foreman, {Marilyn G.} and Hanania, {Nicola A.} and Ireland, {Belinda K.} and Nathaniel Marchetti and Marciniuk, {Darcy D.} and Mularski, {Richard A.} and Joseph Ornelas and Road, {Jeremy D.} and Stickland, {Michael K.}",
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Criner, GJ, Bourbeau, J, Diekemper, RL, Ouellette, DR, Goodridge, D, Hernandez, P, Curren, K, Balter, MS, Bhutani, M, Camp, PG, Celli, BR, Dechman, G, Dransfield, MT, Fiel, S, Foreman, MG, Hanania, NA, Ireland, BK, Marchetti, N, Marciniuk, DD, Mularski, RA, Ornelas, J, Road, JD & Stickland, MK 2015, 'Prevention of Acute Exacerbations of COPD: American College of Chest Physicians and Canadian Thoracic Society Guideline', Chest, vol. 147, no. 4, pp. 894-942. https://doi.org/10.1378/chest.14-1676

Prevention of Acute Exacerbations of COPD : American College of Chest Physicians and Canadian Thoracic Society Guideline. / Criner, Gerard J.; Bourbeau, Jean; Diekemper, Rebecca L.; Ouellette, Daniel R.; Goodridge, Donna; Hernandez, Paul; Curren, Kristen; Balter, Meyer S.; Bhutani, Mohit; Camp, Pat G.; Celli, Bartolome R.; Dechman, Gail; Dransfield, Mark T.; Fiel, Stanley; Foreman, Marilyn G.; Hanania, Nicola A.; Ireland, Belinda K.; Marchetti, Nathaniel; Marciniuk, Darcy D.; Mularski, Richard A.; Ornelas, Joseph; Road, Jeremy D.; Stickland, Michael K.

In: Chest, Vol. 147, No. 4, 01.04.2015, p. 894-942.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Prevention of Acute Exacerbations of COPD

T2 - American College of Chest Physicians and Canadian Thoracic Society Guideline

AU - Criner, Gerard J.

AU - Bourbeau, Jean

AU - Diekemper, Rebecca L.

AU - Ouellette, Daniel R.

AU - Goodridge, Donna

AU - Hernandez, Paul

AU - Curren, Kristen

AU - Balter, Meyer S.

AU - Bhutani, Mohit

AU - Camp, Pat G.

AU - Celli, Bartolome R.

AU - Dechman, Gail

AU - Dransfield, Mark T.

AU - Fiel, Stanley

AU - Foreman, Marilyn G.

AU - Hanania, Nicola A.

AU - Ireland, Belinda K.

AU - Marchetti, Nathaniel

AU - Marciniuk, Darcy D.

AU - Mularski, Richard A.

AU - Ornelas, Joseph

AU - Road, Jeremy D.

AU - Stickland, Michael K.

PY - 2015/4/1

Y1 - 2015/4/1

N2 - BACKGROUND:COPD is a major cause of morbidity and mortality in the United States as well as throughout the rest of the world. An exacerbation of COPD (periodic escalations of symptoms of cough, dyspnea, and sputum production) is a major contributor to worsening lung function, impairment in quality of life, need for urgent care or hospitalization, and cost of care in COPD. Research conducted over the past decade has contributed much to our current understanding of the pathogenesis and treatment of COPD. Additionally, an evolving literature has accumulated about the prevention of acute exacerbations. METHODS:In recognition of the importance of preventing exacerbations in patients with COPD, the American College of Chest Physicians (CHEST) and Canadian Thoracic Society (CTS) joint evidence-based guideline (AECOPD Guideline) was developed to provide a practical, clinically useful document to describe the current state of knowledge regarding the prevention of acute exacerbations according to major categories of prevention therapies. Three key clinical questions developed using the PICO (population, intervention, comparator, and outcome) format addressed the prevention of acute exacerbations of COPD: nonpharmacologic therapies, inhaled therapies, and oral therapies. We used recognized document evaluation tools to assess and choose the most appropriate studies and to extract meaningful data and grade the level of evidence to support the recommendations in each PICO question in a balanced and unbiased fashion. RESULTS:The AECOPD Guideline is unique not only for its topic, the prevention of acute exacerbations of COPD, but also for the first-in-kind partnership between two of the largest thoracic societies in North America. The CHEST Guidelines Oversight Committee in partnership with the CTS COPD Clinical Assembly launched this project with the objective that a systematic review and critical evaluation of the published literature by clinical experts and researchers in the field of COPD would lead to a series of recommendations to assist clinicians in their management of the patient with COPD. CONCLUSIONS:This guideline is unique because it provides an up-to-date, rigorous, evidence-based analysis of current randomized controlled trial data regarding the prevention of COPD exacerbations.

AB - BACKGROUND:COPD is a major cause of morbidity and mortality in the United States as well as throughout the rest of the world. An exacerbation of COPD (periodic escalations of symptoms of cough, dyspnea, and sputum production) is a major contributor to worsening lung function, impairment in quality of life, need for urgent care or hospitalization, and cost of care in COPD. Research conducted over the past decade has contributed much to our current understanding of the pathogenesis and treatment of COPD. Additionally, an evolving literature has accumulated about the prevention of acute exacerbations. METHODS:In recognition of the importance of preventing exacerbations in patients with COPD, the American College of Chest Physicians (CHEST) and Canadian Thoracic Society (CTS) joint evidence-based guideline (AECOPD Guideline) was developed to provide a practical, clinically useful document to describe the current state of knowledge regarding the prevention of acute exacerbations according to major categories of prevention therapies. Three key clinical questions developed using the PICO (population, intervention, comparator, and outcome) format addressed the prevention of acute exacerbations of COPD: nonpharmacologic therapies, inhaled therapies, and oral therapies. We used recognized document evaluation tools to assess and choose the most appropriate studies and to extract meaningful data and grade the level of evidence to support the recommendations in each PICO question in a balanced and unbiased fashion. RESULTS:The AECOPD Guideline is unique not only for its topic, the prevention of acute exacerbations of COPD, but also for the first-in-kind partnership between two of the largest thoracic societies in North America. The CHEST Guidelines Oversight Committee in partnership with the CTS COPD Clinical Assembly launched this project with the objective that a systematic review and critical evaluation of the published literature by clinical experts and researchers in the field of COPD would lead to a series of recommendations to assist clinicians in their management of the patient with COPD. CONCLUSIONS:This guideline is unique because it provides an up-to-date, rigorous, evidence-based analysis of current randomized controlled trial data regarding the prevention of COPD exacerbations.

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Criner GJ, Bourbeau J, Diekemper RL, Ouellette DR, Goodridge D, Hernandez P et al. Prevention of Acute Exacerbations of COPD: American College of Chest Physicians and Canadian Thoracic Society Guideline. Chest. 2015 Apr 1;147(4):894-942. https://doi.org/10.1378/chest.14-1676