The Saudi guidelines for the diagnosis and management of COPD

Javed H Khan; Hani M. S. Lababidi; Mohamed S Al-Moamary; Mohammed O Zeitouni; Hamdan H AL-Jahdali; Omar S Al-Amoudi; Siraj O Wali; Majdy M Idrees; Abdullah A Al-Shimemri; Mohammed O Al Ghobain; Hassan S Alorainy; Mohamed S Al-Hajjaj

doi:10.4103/1817-1737.128843

Official publication of the Saudi Thoracic Society, affiliated to King Saud University

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GUIDELINES

Year : 2014 | Volume : 9 | Issue : 2 | Page : 55-76

The Saudi guidelines for the diagnosis and management of COPD

Javed H Khan¹, Hani M. S. Lababidi², Mohamed S Al-Moamary³, Mohammed O Zeitouni⁴, Hamdan H AL-Jahdali³, Omar S Al-Amoudi⁵, Siraj O Wali⁵, Majdy M Idrees⁶, Abdullah A Al-Shimemri³, Mohammed O Al Ghobain³, Hassan S Alorainy⁴, Mohamed S Al-Hajjaj⁷
¹ Department of Medicine, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia
² Department of Medicine, King Fahad Medical City, Riyadh, Saudi Arabia
³ College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
⁴ Department of Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
⁵ College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
⁶ Department of Medicine, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
⁷ College of Medicine, King Saud University, Riyadh, Saudi Arabia

Correspondence Address:
Mohamed S Al-Hajjaj
Department of Medicine, College of Medicine, King Saud University, Riyadh
Saudi Arabia

Source of Support: SICAD received full and unlimited support from the Saudi Thoracic Society. No direct or indirect support was received from pharmaceutical or medical equipment industry during the process of the development of this guideline, Conflict of Interest: This guideline was solely sponsored by the Saudi Thoracic Society. The authors did not have shared interest with pharmaceutical or medical equipments.

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DOI: 10.4103/1817-1737.128843

The Saudi Thoracic Society (STS) launched the Saudi Initiative for Chronic Airway Diseases (SICAD) to develop a guideline for the diagnosis and management of chronic obstructive pulmonary disease (COPD). This guideline is primarily aimed for internists and general practitioners. Though there is scanty epidemiological data related to COPD, the SICAD panel believes that COPD prevalence is increasing in Saudi Arabia due to increasing prevalence of tobacco smoking among men and women. To overcome the issue of underutilization of spirometry for diagnosing COPD, handheld spirometry is recommended to screen individuals at risk for COPD. A unique feature about this guideline is the simplified practical approach to classify COPD into three classes based on the symptoms as per COPD Assessment Test (CAT) and the risk of exacerbations and hospitalization. Those patients with low risk of exacerbation (<2 in the past year) can be classified as either Class I when they have less symptoms (CAT < 10) or Class II when they have more symptoms (CAT ≥ 10). High-risk COPD patients, as manifested with ≥2 exacerbation or hospitalization in the past year irrespective of the baseline symptoms, are classified as Class III. Class I and II patients require bronchodilators for symptom relief, while Class III patients are recommended to use medications that reduce the risks of exacerbations. The guideline recommends screening for co-morbidities and suggests a comprehensive management approach including pulmonary rehabilitation for those with a CAT score ≥10. The article also discusses the diagnosis and management of acute exacerbations in COPD.

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