Best Practices for Treating COPD in Primary Care Reviewed

Posted by: admin on: April 18, 2011

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Global mortality rates from COPD are projected to increase by 30% over the next decade, and by 2030, COPD will be the third leading cause of death, Primary care clinicians often are the first providers to see a patient with COPD and may be the only clinicians to treat those patients.

Accurate diagnosis, particularly differentiation from asthma, is the cornerstone of effective management. Spirometric assessment is the best and most accurate method for diagnosing COPD. Spirometry should be performed before and after bronchodilator therapy: if the patient has asthma, the forced expiratory volume in 1 second (FEV1) usually returns to normal after therapy, whereas in COPD “values rarely, if ever, return to normal.” Yet spirometry is underused in primary care practices.

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The use of calcium supplements without co-administered vitamin D is associated with an increased risk of MI

Most guidelines for the prevention or treatment of osteoporosis recommend the use of calcium supplements, despite the fact that they reduce the risk of fracture only marginally

Studies have yielded conflicting results about their use, with some observational studies suggesting that high calcium intake is protective against vascular disease, and others showing that calcium supplements speed vascular calcification and increase mortality in patients with kidney failure and increase cardiovascular events and MI in women.

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