Introduction: The organization of care for chronic non-infectious diseases, notably COPD, is a common preoccupation in developed countries in which this disease is among the main causes of mortality and disability. We report a summary of a workshop organized on this theme in April 2013 by the Société de pneumologie de langue française.
Background: Experts from several European countries presented the organizational practices for the management of COPD in their countries, in particular the detection of the disease and the systems of care. The common objectives were to obtain better motivation to stop smoking, earlier detection of the disease and education in the recognition of the signs of exacerbation and their severity. The experts agreed that mass detection is of little benefit and difficult to organize. Early individual screening is preferable on the basis of precise, easily identified criteria. The classification recommended by the GOLD committee since 2011 does not seem to be adopted universally throughout Europe. If there is a real improvement over the previous classification due to taking into account clinical criteria, quality of life and exacerbations, criticisms have arisen concerning the choice of certain pathways and therapeutic recommendations not based on prospective studies with a high level of evidence.
Conclusion: European experiences concerning the management of COPD are varied and complementary. One remaining question is who to screen: all subjects at risk (all smokers, all occupations at risk), only symptomatic subjects, subjects with severe and disabling symptoms?
Keywords: Bronchopneumopathie chronique obstructive; Chronic obstructive pulmonary disease; Dépistage; Epidemiology; Screening; Tabagisme; Tobacco smoking; Traitement; Treatment; Épidémiologie.
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