Guía de práctica clínica sobre el diagnóstico, manejo y seguimiento de la enfermedad pulmonar obstructiva crónica en Colombia 2023

This is the authors' abstract. We don't add key points for this paper.

Introduction: Chronic obstructive pulmonary disease (COPD) represents a significant challenge both in the economic and public health realms, both globally and within the Colombian context. This condition not only affects the patients who suffer from it, but also impacts their caregivers and the healthcare system. An increase in absenteeism has been observed both among patients and their family members, resulting in economic losses and missed employment opportunities, further exacerbating the adverse impact on the individual and their family environment. The purpose of this clinical guideline is to establish evidence-based guidelines to improve medical care and resource management in the treatment of COPD within the Colombian population. Objective: This evidence-informed clinical practice guideline (CPG) from the Asociación Colombiana de Neumología y Cirugía de Tórax (Asoneumocito), Asociación Colombiana de Medicina Interna (ACMI) y Asociación colombiana de medicina familiar (SOCMEF) y Asociación Colombiana de Fisioterapia (ASCOFI), aims to support patients, health professionals, and other actors in making decisions about diagnosis. approach, prognosis, and management of adults with COPD in the Colombian context. Materials and methods: The COPD Committee of Asoneumocito, by delegation of the presidency of the latter, formed a multidisciplinary panel of experts to balance and minimize the potential bias arising from conflicts of interest and invited the other associations that were part of this guide. The Universidad de los Andes coordinated and developed the updating or de novo of systematic reviews of the literature according to the GRADE methodology (Grading of Recommendations Assessment, Development and Evaluation). The COPD committee asked a series of questions that the expert panel prioritized, as well as outcomes according to their importance to healthcare professionals and patients. We used the Evidence-to-Decision (EtD) frameworks developed by the GRADE working group, which were subject to public comment. Results: The panel developed 10 evidence-based recommendations for the management of patients with COPD who received any of the following interventions: long-term oxygen therapy, vaccination against influenza viruses, pulmonary rehabilitation, long-acting anticholinergic inhalation therapy, triple therapy inhalation therapy, nutritional supplements, adjunctive therapy with azithromycin, smoking cessation with varenicline, and alpha-1 antitrypsin replacement. Conclusions: The recommendations included in this guide were developed for the Colombian context. The panel considered that there is a need to develop studies of economic evaluations, as well as the impact of the interventions evaluated in areas such as equity, acceptability, and feasibility of implementation in Colombia.