Abstract
Background
In the absence of clarity in national guidelines, this study aimed to reach a consensus among experts in chronic obstructive pulmonary disease (COPD) regarding when medication should be initiated or changed in patients demonstrating a gradual decline.
Methods
An electronic three-stage Delphi exercise was undertaken with 37 leading UK experts in COPD. The panel submitted criteria which they scored in subsequent rounds. Consensus was defined as ≥80% of the panel scoring an item as important.
Results
Consensus was reached on seven criteria: decreased exercise tolerance (97%); increased breathlessness at rest or on exertion (97%); quality of life impairment (91%); low or reduced oxygen saturations based on pulse oximetry readings (86%); ability to perform activities of daily living independently (85%); increase in sputum (80%); and increase in wheeze (80%).
Conclusions
These criteria could be used to guide clinical practice. Empirical research is now required to test their reliability and validity.
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Upton, J., McCutcheon, E., Loveridge, C. et al. What provokes experienced COPD clinical practitioners in the UK to initiate or change medication? A consensus study. Prim Care Respir J 20, 155–160 (2011). https://doi.org/10.4104/pcrj.2011.00008
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DOI: https://doi.org/10.4104/pcrj.2011.00008
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