Chronic Obstructive Pulmonary Disease Management in the Real World: The Importance of a Holistic Assessment

Chronic obstructive pulmonary disease (COPD) is a prevalent condition in smokers that is often underdiagnosed. It offers significant challenges in daily primary healthcare practice as the disease needs a holistic approach. The wait times for appointments with the family doctor are longer than desired; its duration is short and inadequate for the complex and time-consuming approach to COPD; spirometry can only be performed in secondary healthcare services, limiting its assessment in a timely manner; and pulmonary rehabilitation is nonexistent in our primary healthcare context. These are some examples of the resource scarcity we face. In addition, the patient's low literacy towards COPD obstructs behavioural change and treatment compliance. Reporting a clinical case from our reality aims to improve our practice by reflecting on points to target next in a continual training and learning process within our teams. We present the case of a 55-year-old man with COPD type E, a current smoker, with severe exacerbations over the course of a year. These required a closer follow-up, with the involvement of more healthcare professionals, from different areas of expertise, and regular non-pharmacological therapeutic interventions. We discuss the challenges we have faced, from the patient's and healthcare team's perspective, towards an integrated approach.