A COPD Primer

In 2012 we received a grant from the Veterans Health Administration Office of Specialty Care entitled, "Patient-Centered Model for the Management of Chronic Obstructive Pulmonary Disease." The grant's goals were to enhance the recognition and diagnosis of COPD and implement a Patient-Centered Model for the Management of COPD. As the work on that proposal progressed, we realized that providers did not have an up-to-date, comprehensive, easily read, "how to" manual for the management of COPD despite all the advances in COPD care that have occurred over the past 5 years. Consensus documents such as the VA-DOD Guidelines were abbreviated summaries that were rarely used. From those discussions, the concept for this volume, a COPD Primer, developed. The goal was to develop a practical book that concisely presented COPD to providers with sufficient background and explanation of the physiologic and scientific rationale for various management strategies without becoming an esoteric academic work. We hope that this COPD Primer has achieved that goal and will be a useful, practical text for practitioners and medical trainees alike.
The COPD Primer begins with an examination of what COPD is; it is really a syndrome, a constellation of historical features and clinical, physiologic, and radiographic findings. However, those elements come together in many different ways to create multiple different COPD phenotypes that are only now being recognized and used to define specific management strategies. COPD research has progressed beyond the simple classification of "blue bloaters" and "pink puffers." Next, the epidemiology and economic consequences of COPD are reviewed. Bill Eschenbacher presents an approach to the patient with respiratory symptoms with detailed discussions of pulmonary function testing and how airflow limitation/obstruction is identified by spirometry and the use of lung imaging to identify individuals with COPD. Michael Borchers and Gregory Motz summarize current