Outpatient management of chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease (COPD) constitutes a large part of the work load of Respiratory Physicians. Guidelines for its management have been published in the U.S.A. (l), and the European Respiratory Society is currently addressing this issue. However, to date, guidelines have not been published in the U.K. Ideally, guidelines should be based on the findings of scientific research, where the effects of specific intervention on outcome are examined. However, for many of the different drugs and interventions available to patients with COPD, there is only limited data to support one approach over another. Consequently, any guidelines produced for this condition will have to be largely consensus-based, and is representative of what is generally felt to be good practice. The authors have examined the outpatient management of patients with COPD by Respiratory Physicians in one Health Region of the IJ.K., in order to establish whether their practice appears significantly uniform to readily permit the formation of consensus guidelines.