June 2, 2016

COPD-X Guidelines Update 1st QTR 2016

The COPD-X guidelines have been updated with the latest version released 2nd June, 2016. The update includes changes in the areas of lung volume reduction surgery, lung transplantation and oxygen therapy.

Lung Foundation Australia announced the recent update to The COPD-X Plan: Australian and New Zealand Guidelines for the Management of COPD after an extensive review of the published evidence in COPD up to 18 March 2016.  Click here to view a full list of the updates.

At an international level, COPD-X is one of the most regularly updated COPD guidelines with evidence-based revisions conducted every quarter.

Here are highlights of some of the changes:

Lung volume reduction surgery and other techniques

Inclusion of new evidence on the use of endobronchial valves which details that endobronchial valves may provide a benefit to highly selected patients but should only be considered in specialised centres and cannot yet be recommended as routine therapy.

Inclusion of new wording on lung volume reduction coil treatment as a result of the largest non-blinded randomised controlled trial conducted to date. The study showed improvements in the 6 minute walk distance at 6 months, but not 12 months.  However there were sustained improvements in spirometry and quality of life at 12 months. Cost effectiveness analysis found the treatment to be prohibitively expensive.

Lung transplantation

This section was reviewed including the type of patients who should be referred to a transplant centre and those in whom lung transplantation is contraindicated.  The update also includes expected one, five and 10 year survival rates post-transplant.

Oxygen therapy

A substantial review of the “Intermittent Oxygen Therapy” sub-section which states that ambulatory oxygen therapy should not be offered routinely to patients who do not qualify for long term oxygen therapy.  However, the use of short-term intermittent oxygen therapy may be considered for people who experience oxygen desaturation on exertion; patients living in isolated areas or prone to sudden life- threatening episodes while they are awaiting medical attention or evacuation by ambulance; and patients travelling by air. In addition a sub-section called “Ambulatory oxygen therapy during pulmonary rehabilitation” has been added.

Chair, Lung Foundation COPD Executive Committee and Respiratory Physician at Austin Hospital, Professor Christine McDonald said the COPD-X Guidelines were a vital tool to assist health professionals in keeping abreast of the latest medicines and treatment options for patients with COPD.

“Given the complexities in COPD management the COPD-X Guidelines are a valuable source to have on hand and refer to for the most up to date evidence. Quarterly updates ensure emerging therapies are included in a very timely manner.”

Professor McDonald reinforces that, “The best plan for patients is to talk to a respiratory specialist about the treatment options that are best suited to them and their unique circumstances.’’

Lung Foundation Australia CEO, Heather Allan, said the Lung Foundation plays a key role in translating the evidence so it makes sense to both clinicians and patients and is easily accessible. “Anyone living with or affected by COPD can make contact with us for the information and support they need.  For example, we have up to date, reliable information on Home Oxygen Therapy including oxygen equipment, subsidies, and tips on staying active and travelling with oxygen.”

For more information call Lung Foundation Australia’s free call information support line: 1800 654 301 or visit www.lungfoundation.com.au.

 

References

  1. Toelle B, Xuan W, Bird T, Abramson M, Atkinson D, Burton D, James A, Jenkins C, Johns D, Maguire G, Musk A, Walters E, Wood-Baker R, Hunter M, Graham B, Southwell P, Vollmer W, Buist A, Marks G. Respiratory symptoms and illness in older Australians: The Burden of Obstructive Lung Disease (BOLD) study. Med J Aust 2013;198:144-148
  1. AIHW 2014 http://www.aihw.gov.au/copd/
  1. O’Donnell DE, Bourbeau J, Hernandez P, Marciniuk DD, Balter M, et al. Canadian Thoracic Society recommendations for management of chronic obstructive pulmonary disease – 2007 update. Canadian Respiratory Journal 2007; 14 (Suppl B):5B-32B.