Each quater, iCAHE will feature a guideline. Each guideline will be scored using the iCAHE Guideline Quality Checklist. This is a regular feature in our newsletter, Allied and Scientific Health News.
The COPD-X Plan: Australian and New Zealand Guidelines for the management of Chronic Obstructive Pulmonary Disease (2018)
These guidelines are the outcome of a joint project of the Thoracic Society of Australia and New Zealand and Lung Foundation Australia. The guidelines aim to effect changes in clinical practice based on sound evidence; and shift the emphasis from a predominant reliance on pharmacological treatment of COPD to a range of interventions which include patient education, self-management of exacerbations and pulmonary rehabilitation. These guidelines deal mainly with the management of established disease and exacerbations. However, this is only one element of the COPD Strategy of Lung Foundation Australia, which has the long-term goals of primary prevention of smoking; improving rates of smoking cessation; early detection of airflow limitation in smokers before disablement; and improved management of stable disease and prevention of exacerbations.
Recommendations from the guideline that are relevant to this review include:
- To confirm diagnosis referral to specialist respiratory services may be required (NHMRC level of evidence: III-2, Strength of recommendation: Strong)
- Non-pharmacological strategies (such as pulmonary rehabilitation and regular exercise) should be provided to all patients with COPD (NHMRC level of evidence: I, Strength of recommendation: Strong)
- Patients may benefit from support groups and other community services (NHMRC level of evidence: III-2, Strength of recommendation: Weak)
- Multidisciplinary care may assist home management of some patients with an exacerbation (NHMRC level of evidence: I, Strength of recommendation: Weak)
- Consider pulmonary rehabilitation at any time, including during the recovery phase following an exacerbation (NHMRC level of evidence: I, Strength of recommendation: Strong)
- Patients with COPD discharged from hospital following an exacerbation should receive comprehensive follow-up led by the primary healthcare team (NHMRC level of evidence: I, Strength of recommendation: Strong)
For more guidelines, make sure to check out the iCAHE guidelines clearing house.
The guideline scores 12/14 on the iCAHE Guideline Quality Checklist and is freely available online at https://copdx.org.au/
iCAHE Guideline quality Checklist (pdf 154kb)
Key characteristics unique to a clinical guideline, a care pathway and a practice protocol are discussed in the iCAHE textbook: Practical Tips for using and developing guidelines: An Allied Health Primer.