Proceedings of the American Thoracic Society
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The Proceedings of the American Thoracic Society 6:704-706 (2009)
© 2009 The American Thoracic Society
doi: 10.1513/pats.200907-062DP
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Primary Prevention of Chronic Obstructive Pulmonary Disease in Primary Care

Thys van der Molen1 and Siebrig Schokker1

1 Department of General Practice, University Medical Center Groningen, University of Groningen, The Netherlands

Correspondence and requests should be addressed to T. van der Molen, M.D., Ph.D., Department of General Practice, University Medical Center Groningen, A. Deusinglaan 1, 9713 AV Groningen, The Netherlands. E-mail: t.van.der.molen{at}med.umcg.nl

ABSTRACT

Chronic obstructive pulmonary disease (COPD) is a prevalent disease, with cigarette smoking being the main risk factor. Prevention is crucial in the fight against COPD. Whereas primary prevention is targeted on whole populations, patient populations are the focus of primary care; therefore, prevention in this setting is mainly aimed at preventing further deterioration of the disease in patients who present with the first signs of disease (secondary prevention). Prevention of COPD in primary care requires detection of COPD at an early stage. An accurate definition of COPD is crucial in this identification process. The benefits of detecting new patients with COPD should be determined before recommending screening and case-finding programs in primary care. No evidence is available that screening by spirometry results in significant health gains. Effective treatment options in patients with mild disease are lacking. Smoking cessation is the cornerstone of COPD prevention. Because cigarette smoking is not only a major cause of COPD but is also a major cause of many other diseases, a decline in tobacco smoking would result in substantial health benefits.

Key Words: COPD • prevention • diagnosis • primary care






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