A Simplified Algorithm for the Diagnosis, Treatment, and Management of COPD in Routine Primary Care Practice

Area of Science:

• Pulmonology
• Primary Care Medicine
• Clinical Algorithm Development

Background:

• Chronic obstructive pulmonary disease (COPD) management often deviates from evidence-based guidelines in primary care settings.
• Difficulties in applying complex guidelines hinder consistent COPD diagnosis and treatment.
• A need exists for a simplified, practical approach to COPD care in routine practice.

Purpose of the Study:

• To develop a simplified algorithm for diagnosing, treating, and managing COPD in primary care.
• To ensure the algorithm's consistency, scientific relevance, and applicability through expert validation.
• To improve adherence to evidence-based COPD management in primary care.

Main Methods:

• A multi-phase development process involving preliminary meetings and an input meeting with family doctors (FDs) and pulmonologists.
• Algorithm refinement and validation using a Delphi survey with FDs and pulmonologists.
• Consensus-building through iterative Delphi rounds, targeting at least 75% approval for each item.

Main Results:

• 118 physicians (75 FDs, 43 pulmonologists) participated in the Delphi process.
• The algorithm achieved expert approval after two Delphi rounds, with dyspnea identified as the key determinant for treatment decisions.
• The final algorithm was validated for face validity by participating physicians.

Conclusions:

• The developed simplified COPD algorithm is considered a clear, functional, and useful tool for primary care.
• The algorithm meets the requirements for effective COPD management in routine clinical practice.
• Expert consensus supports the algorithm's applicability and potential to improve COPD care.