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Related Concept Videos

Chronic Obstructive Pulmonary Disease-V: Management01:29

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Managing Chronic Obstructive Pulmonary Disease (COPD) involves a multifaceted approach to reduce symptoms, prevent exacerbations, improve overall health status, and slow disease progression. Key strategies include lifestyle modifications, pharmacotherapy, supportive therapies, and, in some cases, surgery. Here is an overview of the primary COPD management strategies:
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Chronic obstructive pulmonary isease (COPD) involves a group of progressive lung disorders characterized by persistent airflow limitation and chronic respiratory symptoms. Asthma-COPD Overlap Syndrome (ACOS), encompassing features of both asthma and Chronic obstructive pulmonary disease (COPD), is a group of progressive lung disorders that includes chronic bronchitis, emphysema, and refractory (non-reversible) asthma. ACOS leads to complex clinical presentations that combine the inflammatory...
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COPD: Pathogenesis and Clinical Features01:20

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Chronic obstructive pulmonary disease (COPD) is a group of lung conditions that progressively worsen over time, including chronic bronchitis and emphysema. This cluster of diseases collectively leads to a gradual and irreversible decline in lung function over time.
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Chronic Obstructive Pulmonary Disease-I: Introduction01:20

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Chronic Obstructive Pulmonary Disease (COPD) is a long-lasting respiratory condition requiring continuous attention and care. It is a progressive lung disease that leads to breathing challenges due to airflow obstruction. It manifests as persistent respiratory symptoms and restricted airflow resulting from abnormalities in the airways and alveoli, usually due to long-term exposure to harmful particles or gases. COPD mainly consists of two primary conditions: emphysema and chronic bronchitis.
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Nursing management of Chronic Obstructive Pulmonary Disease (COPD) is crucial for providing thorough care and support to patients. Nurses play an integral role in this process through detailed assessment, careful planning, targeted interventions, and ongoing evaluation. Here's an overview of the critical steps in nursing management for COPD.
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Chronic Obstructive Pulmonary Disease01:22

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COPD is defined as a heterogeneous lung condition marked by persistent respiratory symptoms such as dyspnea, cough, and sputum production, caused by abnormalities in the airways that cause airflow obstruction.
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Updated: Jan 11, 2026

Home-Based Prescribed Pulmonary Exercise in Patients with Stable Chronic Obstructive Pulmonary Disease
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Difficult-to-treat COPD: from concept to practice.

Lucile Regard1, Nicolas Roche1

  • 1Respiratory Medicine, Cochin Hospital, APHP Centre, Paris, France; Université Paris Cité, Institut Cochin, INSERM UMR 1016 Paris, France.

Presse Medicale (Paris, France : 1983)
|November 11, 2025
PubMed
Summary
This summary is machine-generated.

Patients with difficult-to-treat Chronic Obstructive Pulmonary Disease (COPD) require reassessment beyond standard care. Focusing on dynamic disease control, not just fixed targets, guides personalized management strategies for better outcomes.

Keywords:
BiotherapyCOPDControlDyspneaExacerbationsInhaled maintenance therapy

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Area of Science:

  • Pulmonary Medicine
  • Respiratory Disease Research
  • Clinical Management Strategies

Background:

  • Many Chronic Obstructive Pulmonary Disease (COPD) patients remain symptomatic or experience disease progression despite standard treatments.
  • A subset of patients, termed 'difficult-to-treat COPD,' lacks a formal definition and requires tailored management approaches.
  • Current management often focuses on fixed treatment targets rather than dynamic disease control.

Purpose of the Study:

  • To propose disease control as a dynamic construct for managing COPD, drawing parallels with asthma management.
  • To provide a framework for reassessing patients with uncontrolled COPD, focusing on diagnosis, treatment adequacy, and underlying drivers.
  • To advocate for a shift from treatment escalation to recharacterization for patients not responding to guideline-concordant care.

Main Methods:

  • Reviewing core domains of uncontrolled COPD: persistent dyspnea, chronic bronchitis, exacerbations, and lung function decline.
  • Exploring clinical reasoning, diagnostic tools, and phenotype/endotype-specific strategies for treatable traits.
  • Examining advanced therapeutic pathways beyond standard care, including biologics, lung volume reduction, and palliative care.

Main Results:

  • Disease control in COPD should be viewed as a dynamic state reflecting daily impact and long-term stability.
  • A structured reassessment framework helps identify unresolved pathophysiological drivers in uncontrolled COPD.
  • Shifting the paradigm to recharacterization is crucial for patients refractory to standard therapies.

Conclusions:

  • Implementing multidisciplinary case discussions and using loss of disease control as a trigger for reassessment is recommended.
  • A dynamic, precision-based approach aligning treatment with evolving COPD trajectories is advocated.
  • The goal is to optimize management for difficult-to-treat COPD by focusing on personalized, adaptive strategies rather than defining new phenotypes.