The PRAXIS Nexus The PRAXIS Nexus

The COPD Revolution: New Paradigms In Diagnosis and Management

Posted on February 12, 2024   |   

This post was written by Michael W. Hess, MPH, RRT, RPFT

This may come as a surprise to many, but when I first started as a respiratory therapist, I didn't really think about COPD very much. Sure, I saw the "frequent flyers" coming in through the ER for their tune-ups, and I would dutifully show up every four hours out on the floors with my trusty albuterol and ipratropium. Being a child of the 80s, I usually used its brand name so I could them "the A-Team." I even took care of the really rough cases up in the ICU, where debates about matching intrinsic PEEP and other ventilation strategies seemed to be the most interesting aspect of treating this condition. This attitude was no outlier either; COPD was not on very many people's radars at all. The very first Global Initiative for Chronic Obstructive Lung Disease (GOLD) strategy report was a mere five years old; the COPD Foundation itself was even younger. We had no endobronchial valves, far fewer pharmaceuticals, relatively little noninvasive ventilation in the home. Limited options led to therapeutic nihilism which led to viewing COPD as just not a priority. In other words, there's nothing we can really do, so why spend much time thinking about it?

Obviously, my views have changed over the last couple of decades. Fortunately, the prevailing views of health care have largely changed along with me. These days, we know there is a great deal we can do for members of the COPD community to help them live healthier, more active lives. We are seeing the growth of "care navigator" roles that focus specifically on getting people through the complexities of managing therapy plans. We here at the Foundation are celebrating our twentieth anniversary in 2024 and as a part of that, we are proud to have launched a new educational resource highlighting the new horizons of the COPD world.

In January, we published the New Paradigms in COPD resource as an update to our 101 Library. New Paradigms in COPD takes the latest research and treatment philosophies from the last year's GOLD report, the 2022 report from the Lancet Commission on eliminating COPD, the Rome Proposal regarding COPD exacerbation management, and other leading sources and distills them for you with a clear, concise style. It is available in both PDF and PowerPoint formats so you can use it as a reference or teaching tool. As with all entries in the 101 Library, New Paradigms in COPD gives you immediately actionable suggestions that can positively impact your patient panel right away.

New Paradigms in COPD also highlights the challenges and opportunities that COPD research presents so that clinicians can ask the right questions, both in the clinical and scientific settings. As we increase our understanding of this condition, it becomes clear that we can no longer focus on single aspects of treatment or management to help our patients; we must instead treat COPD as the whole-body-and-mind condition it is. That's why we made sure to include information on behavioral health interventions, managing comorbidities, and considerations for end-of-life care. Even though it is part of the 101 Library, we decided to go a bit beyond the basics with New Paradigms in COPD so that you can be better prepared to manage COPD care, no matter the level of severity.

We are excited to see COPD become a higher priority for the global health care system, and we are very proud to continue leading the way in both patient and clinician education. New Paradigms in COPD is an example of our commitment to improving care until we find a cure. Take a look and let us know what you think!


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  • I went to my first ATS conference in 2007. The big discussion was on Bart Celli's talk on "Nihilism in COPD"; he was a was a great opponent, giving us few patients at that conference a new hero, and some ideas we could present to our own pulmonologists about treatments, rather than sympathy and a gentle reminder to "put our affairs in order". I was fresh off an aggressive diet and exercise program that had resulted in a weight loss of over 100 pounds, an exercise habit I haven't given up yet, improvements in just about every aspect of my daily life, reductions in meds, getting off 02 completely for over 10 years and a new wardrobe. My friend, Edna Fiore, introduced me to Dr. Celli, told him what I had done and we've been friends ever since. I've always been grateful to Edna, who introduced me to practically every pulmonologist she knew at that conference and several subsequent ones as well. She was a great mentor and friend.
  • Yes 2007 was the 1st ATS conference I attended in SF as well. There was a lot of shrugging as many people didn’t think those of us with COPD could be helped much. I had a one hour discussion about the Long Term Oxygen Treatment Trial with Barry Make. It was sad that nearly all the design flaws we discussed were in the trial.

    I’m glad there are more and some better treatments for those of us with COPD and a few promising possibilities.