TY - JOUR
T1 - Strategies for the prevention, diagnosis and treatment of COPD in low- and middle- income countries
T2 - the importance of primary care
AU - Rossaki, Foteini M
AU - Hurst, John R
AU - van Gemert, Frederik
AU - Kirenga, Bruce J
AU - Williams, Siân
AU - Khoo, Ee Ming
AU - Tsiligianni, Ioanna
AU - Tabyshova, Aizhamal
AU - van Boven, Job Fm
PY - 2021
Y1 - 2021
N2 - INTRODUCTION: Low- and middle-income countries (LMICs) bear a high proportion of the global morbidity and mortality caused by COPD. Increased exposure to risk factors throughout life (e.g. malnutrition, indoor and outdoor air pollution, smoking) is associated with higher COPD prevalence in LMICs and the lack of treatment availability increases avoidable harm.AREAS COVERED: This review covers the epidemiology and burden of COPD in LMICs, and challenges and recommendations related to healthcare systems, prevention, diagnosis and treatment. Main challenges are related to under-resourced healthcare systems (such as limited availability of spirometry, rehabilitation and medicines). Lack of policy and practical local guidelines on COPD diagnosis and management further contribute to the low diagnostic and treatment rates. In the absence of, or limited number of respiratory specialists, primary care practitioners (general practitioners, nurses, pharmacists, physiotherapists and community health workers) play an even more pivotal role in COPD management in LMICs.EXPERT OPINION: Raising awareness on COPD, educating healthcare workers, patients and communities on cost-effective preventive measures as well as improving availability, affordability and proper use of diagnostic and pharmacological and non-pharmacologic treatment in primary care are the key interventions needed to improve COPD prevention, diagnosis and care in LMICs.
AB - INTRODUCTION: Low- and middle-income countries (LMICs) bear a high proportion of the global morbidity and mortality caused by COPD. Increased exposure to risk factors throughout life (e.g. malnutrition, indoor and outdoor air pollution, smoking) is associated with higher COPD prevalence in LMICs and the lack of treatment availability increases avoidable harm.AREAS COVERED: This review covers the epidemiology and burden of COPD in LMICs, and challenges and recommendations related to healthcare systems, prevention, diagnosis and treatment. Main challenges are related to under-resourced healthcare systems (such as limited availability of spirometry, rehabilitation and medicines). Lack of policy and practical local guidelines on COPD diagnosis and management further contribute to the low diagnostic and treatment rates. In the absence of, or limited number of respiratory specialists, primary care practitioners (general practitioners, nurses, pharmacists, physiotherapists and community health workers) play an even more pivotal role in COPD management in LMICs.EXPERT OPINION: Raising awareness on COPD, educating healthcare workers, patients and communities on cost-effective preventive measures as well as improving availability, affordability and proper use of diagnostic and pharmacological and non-pharmacologic treatment in primary care are the key interventions needed to improve COPD prevention, diagnosis and care in LMICs.
KW - COPD
KW - TREATMENT ISSUES
KW - GLOBAL HEALTH
KW - low middle income countries
KW - DIAGNOSIS
KW - PHARMACOLOGICAL STRATEGIES
KW - CHRONIC OBSTRUCTIVE LUNG DISEASE
U2 - 10.1080/17476348.2021.1985762
DO - 10.1080/17476348.2021.1985762
M3 - Review article
C2 - 34595990
SN - 1747-6348
VL - 15
SP - 1563
EP - 1577
JO - Expert review of respiratory medicine
JF - Expert review of respiratory medicine
IS - 12
ER -