The Saudi guidelines for the diagnosis and management of COPD

Abstract

The Saudi Thoracic Society (STS) launched the Saudi Initiative for Chronic Airway Diseases (SICAD) to develop a guideline for the diagnosis and management of chronic obstructive pulmonary disease (COPD). This guideline is primarily aimed for internists and general practitioners. Though there is scanty epidemiological data related to COPD, the SICAD panel believes that COPD prevalence is increasing in Saudi Arabia due to increasing prevalence of tobacco smoking among men and women. To overcome the issue of underutilization of spirometry for diagnosing COPD, handheld spirometry is recommended to screen individuals at risk for COPD. A unique feature about this guideline is the simplified practical approach to classify COPD into three classes based on the symptoms as per COPD Assessment Test (CAT) and the risk of exacerbations and hospitalization. Those patients with low risk of exacerbation (<2 in the past year) can be classified as either Class I when they have less symptoms (CAT < 10) or Class II when they have more symptoms (CAT ≥ 10). High-risk COPD patients, as manifested with ≥2 exacerbation or hospitalization in the past year irrespective of the baseline symptoms, are classified as Class III. Class I and II patients require bronchodilators for symptom relief, while Class III patients are recommended to use medications that reduce the risks of exacerbations. The guideline recommends screening for co-morbidities and suggests a comprehensive management approach including pulmonary rehabilitation for those with a CAT score ≥10. The article also discusses the diagnosis and management of acute exacerbations in COPD.

Current care services provided for patients with COPD in the Eastern province in Saudi Arabia: a&nbsp;descriptive study

“… 5 , 6 Although COPD is a serious respiratory disease with an already high and still increasing morbidity and mortality, it is underdiagnosed and underrecognized in Middle Eastern countries, including Saudi Arabia. 7 …”

“…To date, there are several national and international clinical COPD management guidelines such as the recently published Saudi Initiative for Chronic Airway Disease (SICAD) guidelines and the internationally recognized and frequently updated Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. 7 , 16 The SICAD guidelines panel has customized and simplified the GOLD guidelines based on the Saudi setting. 7 , 16 Whereas COPD guidelines are widely accessible, many physicians and pulmonologists are not aware of their existence or do not fully understand them.…”

When should acute exacerbations of COPD be treated with systemic corticosteroids and antibiotics in primary care: a systematic review of current COPD guidelines

“…Only four guidelines recommended conducting additional diagnostic tests: C-reactive protein (CRP), white blood cell count, procalcitonin, and chest radiography ( Table 2 ). The guidelines from India 23 and Saudi 24 emphasised that the use of biomarkers has no role in the assessment of AECOPD. The Dutch guideline was exceptional, as they did not recommend any of the respiratory symptoms.…”

Status of respiratory care profession in Saudi Arabia: A national survey

“…The role of RTs in sub-acute and rehabilitative care has been discussed in the literature. [ 20 21 ] In a country with high prevalence of chronic diseases (asthma, chronic obstructive pulmonary disease, and diabetes)[ 22 23 24 ] and exponential increase in healthcare services, the demand for RTs will continue to be high for the next decade.…”