Medical Treatment of COPD Patients with Mild and Moderate Airflow Obstruction

The prevalence of chronic obstructive pulmonary disease (COPD) is increasing and is now the third most common cause of death in the United States. It is estimated that half of all people in the United States with COPD have not been diagnosed, reflecting factors that include patient delay in seeking help despite symptoms and physician perception that only smoking cessation can improve the course of the disease. Primary care physicians are best placed to identify undiagnosed patients with mild or moderate COPD. Recent evidence from large randomized clinical trials demonstrates that pharmacologic treatments such as tiotropium and salmeterol/fluticasone can benefit patients with mild and moderate COPD, improving lung function, reducing the risk of exacerbations and improving health status. Primary care physicians can help patients and reduce the burden of COPD on healthcare systems by actively assessing patients they suspect may have COPD and treating those diagnosed.