The narrative review of chronic obstructive pulmonary disease management in Turkey: medical treatment, pulmonary rehabilitation and endobronchial volume reduction

Abstract

Chronic obstructive pulmonary disease (COPD) is one of the most common chronic diseases. In Turkey, the prevalence of COPD has been shown at rates of 9.1% to 19.1%, and COPD was found to be the third leading cause of mortality and eighth leading cause of disability. In several national multicentral studies, a high rate of non-adherence to pharmacologic treatment according to GOLD was found to be high, and the most commonly prescribed treatment was the triple regimen. The most important non-pharmacologic treatment of COPD is pulmonary rehabilitation (PR), which is also highly recommended in Turkey, but it is also underutilized, like in other countries. Awareness of healthcare professionals and patients should increase in Turkey. The recommendations in content and modality of programs are similar to international guidelines.Another non-pharmacologic treatment is endobronchial volume reduction (EBVR). Although there is limited number of studies about EBVR, in national reports, the importance of patient selection, method, close follow-up after intervention, and applications in experienced centers are emphasized to decrease the economic burden of this expensive treatment. There is still great need for further randomized studies about pharmacologic and non-pharmacologic treatment and additionally, a close collaboration between healthcare professionals, physicians, professional societies of pulmonology, planners of reimbursement system, patients, patient advocacy groups and the general public should be established.

Neglecting the neglected: Tobacco cessation support is 'essential' for the management of asthma and COPD

“…Furthermore, avoidance of tobacco smoke exposure has been shown to be an unquestionable factor in extending the survival of patients with mild and moderate COPD 3 . Despite this, studies show that approximately 50% of patients with a COPD diagnosis continue to smoke 4,5 , and for asthmatics, that rate was found to be about 20% and 11.4%, in international and national studies, respectively 6,7 . In addition, current smoker patients were found to be more symptomatic and more likely to overuse inhaler treatments 8,9 .…”