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Unmet need in the management of chronic obstructive pulmonary disease in the Middle East and Africa region: An expert panel consensus - 08/12/21

Doi : 10.1016/j.rmed.2021.106641 
Mohamed S. Al-Moamary a, , Nurdan Köktūrk b, Majdy M. Idrees c, Elif Şen d, George Juvelekian e, Wajdy Abi Saleh f, Zaid Zoumot g, Naser Behbehani h, Ashraf Hatem i, Hosam H. Masoud j, Abdelmadjid Snouber k, Richard N. van Zyl-Smit l
a Department of Medicine, College of Medicine, King Saudi Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia 
b Department of Pulmonary Medicine, Gazi University School of Medicine, Ankara, Turkey 
c Department of Medicine, Prince Sultan Military Medical City, Riyadh, Saudi Arabia 
d Department of Pulmonary Medicine, Ankara University School of Medicine, Ankara, Turkey 
e Department of Pulmonary and Critical Care Medicine, Saint George Hospital University Medical Centre, Beirut, Lebanon 
f Lebanese University, Faculty of Medicine, Lebanon 
g Department of Pulmonology, Respiratory Institute, Cleveland Clinic Abu Dhabi, United Arab Emirates 
h Department of Medicine, Kuwait University, Kuwait City, Kuwait 
i Department of Chest Diseases, Faculty of Medicine, Cairo University, Cairo, Egypt 
j Department of Chest Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt 
k Chest Clinic, Faculty of Medicine, University of Oran 1, Algeria 
l Division of Pulmonology and UCT Lung Institute, Department of Medicine, University of Cape Town & Groote Schuur Hospital, Cape Town, South Africa 

Corresponding author. College of Medicine, King Saudi bin Abdulaziz University for Health Sciences, P.O. Box 84252, Riyadh, 11671, Saudi Arabia.College of MedicineKing Saudi bin Abdulaziz University for Health SciencesP.O. Box 84252Riyadh11671Saudi Arabia

Abstract

Chronic obstructive pulmonary disease (COPD) has a significant impact on healthcare systems and health-related quality of life. Increased prevalence of smoking is an important factor contributing to high burden of COPD in the Middle East and Africa (MEA). Several other factors including sedentary lifestyle, urbanization, second-hand smoke, air pollution, and occupational exposure are also responsible for the upsurge of COPD in the MEA. Frequent COPD exacerbations accelerate disease progression, progressively deteriorate the lung function, and negatively affect quality of life. This consensus is based on review of the published evidence, international and regional guidelines, and insights provided by the expert committee members from the MEA region. Spirometry, though the gold standard for diagnosis, is often unavailable and/or underutilized leading to underdiagnosis of COPD in primary care settings. Low adherence to the treatment guidelines and delayed use of appropriate combination therapy including triple therapy are additional barriers in management of COPD in MEA. It is necessary to recognize COPD as a screenable condition and develop easy and simple screening tools to facilitate early diagnosis. Knowledge of the disease symptomatology at patient and physician level and adherence to the international or regional guidelines are important to create awareness about harmful effects of smoking and develop national guidelines to focus on prevention on COPD. Implementation of vaccination program and pulmonary rehabilitation are equally valuable to manage patients with COPD at local and regional level. We present recommendations made by the expert panel for improved screening, diagnosis, and management of COPD in MEA.

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Highlights

Recommendations for management of COPD in the Middle East and Africa (MEA) region.
Barriers include underdiagnosis of COPD, low adherence to the treatment guidelines.
Necessity of recognizing COPD as a screenable condition.
Development of easy and simple screening tools like PUMA to facilitate early diagnosis.
Implementation of vaccination program and pulmonary rehabilitation at local and regional level.

Le texte complet de cet article est disponible en PDF.

Keywords : Chronic obstructive pulmonary disease, Middle East and Africa, Pulmonary rehabilitation, Screenable condition


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Vol 189

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