臺灣分級醫療健康長照促進學會第一屆年度學術大會:

慢性病全人照護與預防醫學新紀元

會議摘要

台灣已進入高齡化社會，需要加強預防醫學的觀念-提前介入避免疾病發生，並促進慢性病患之整合性照護，才能促進國民之健康福祉。本次會議邀請基層醫療以及醫學中心的專家學者共同探討慢性疾病，包含肺阻塞與氣喘。會議邀請專家學者分享後疫情時代基層醫師照護氣喘照病患之策略以及嚴重氣喘的治療新進展。也由專家分享2023 COPD之治療指引及治療新知，並探討氣喘與肺阻塞臨床診斷與治療異同。希冀藉由醫界先進共同交流，能夠推動慢性疾病之分級醫療整合性照護，提升呼吸道疾病患者的生活品質。

會議課程代表摘要:

2023 Report for Prevention, Diagnosis and Management of COPD

Dr. Horng-Chyuan Lin

Department of Thoracic Medicine, Lin-Kou Medical Center of Chang Gung Memorial Hospital, Taiwan, ROC

The GOLD 2023 report defines COPD as “a heterogeneous lung condition characterized by chronic respiratory symptoms (dyspnea, cough, expectoration, exacerbations) due to abnormalities of the airways (bronchitis, bronchiolitis) and/or alveoli (emphysema) that cause persistent, often progressive, airflow obstruction.”. The revised definition of COPD in the 2023 report describes symptoms clearly and underscores the heterogeneity of COPD.

From 2017 to 2022 report, it was recommended that clinicians determine a patient’s initial COPD pharmacologic regimen using the “ABCD Assessment Tool. However, the 2023 GOLD report has further revised this tool, which is now called the “ABE Assessment Tool” which provides the guidance of significant change in COPD pharmacotherapeutic strategy.

The updated report also expands the definition of the severity of an exacerbation by using not only symptoms but also physiologic criteria in grading the exacerbation as mild, moderate, or severe. The Rome Proposal is discussed and suggests that the definition of severity should evolve away from what therapies are used, and rather toward a series of objective parameters: how bad the symptoms are, whether there’s evidence of inflammation or an oxygen saturation problem.

Information on inhaler devices, adherence to medications, therapies and comorbidities has been updated. The focus on education and rehabilitation once again demonstrates the critical role respiratory therapists play in taking care of those people living with COPD.

All in all, the 2023 GOLD Strategy Report may be one of the most significant updates since the very first one. Research should also get a boost from the new sub-definitions of the various types of COPD.