Pharmacological and non-pharmacological management of COPD; limitations and future prospects: a review of current literature

Abstract

Objective

This article aimed to summarize the pharmacological and non-pharmacological management of COPD and limitations and prospects of the currently available pharmacological therapies in the management of COPD.

Background

COPD is a complex comorbid disease that irreversibly affects the pulmonary system and is considered the fifth leading cause of death worldwide. Currently, the diagnosis, assessment and management of COPD are difficult because of its complex syndrome involving numerous pulmonary and extra-pulmonary components. It is diagnosed based on the subjective and objective findings of a chronic cough, sputum production, dyspnoea, exercise intolerance and spirometry values. The GOLD report recommends bronchodilators as the first-line treatment agents in all stages of COPD severity, commonly combined with inhaled corticosteroids (ICS), methylxanthines and antibiotics, depending upon the condition and symptoms of patients. Non-pharmacological treatments of COPD include smoking cessation, influenza and pneumococcal vaccination, pulmonary rehabilitation, LTOT and surgical lung volume reduction. The efficacy of the therapy is directly related to the patients’ inhaler use training and education. A new future in COPD medication is essential to ensure the optimal management of COPD. New alternative sources should be considered in the treatment of COPD.

Conclusion

New approaches such as e-technology can play an essential role in improving compliance and adherence to therapy. New therapies with better and long-lasting effects and minimized side effects need to be discovered to improve the pharmacological management of COPD.