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Respiration. 2019;97(4):363-368. doi: 10.1159/000493759. Epub 2019 Mar 15.

COPD: Rethinking Patient Management - How to Approach a Challenging Patient Group Successfully.

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Department of Respiratory Medicine, Klinikum Würzburg Mitte gGmbH, Würzburg, Germany,
Department of Internal Medicine V - Pulmonology, Allergology, and Intensive Care Medicine, Saarland University Hospital, Homburg, Germany.
Pneumology, Ostseeklinik Schönberg-Holm, Schönberg, Germany.
Department of Pneumology and Intensive Care Medicine, University Hospital Aachen, Aachen, Germany.
Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps University Marburg, German Center for Lung Research (DZL), Marburg, Germany.
Department of Respiratory Medicine and Pulmonary Rehabilitation, Schön Klinik Berchtesgadener Land, Schönau am Königssee, Germany.
Clinical Psychology Practice, Würzburg, Germany.
Respiratory Medicine, Allergology and Sleep Medicine, Kliniken Maria Hilf, Mönchengladbach, Germany.
Clinic for Pneumology and Allergology, Centre of Sleep Medicine and Respiratory Care, Bethanien Hospital, Institute of Pneumology, University of Cologne, Solingen, Germany.


In comparison to other chronically ill people, patients suffering from chronic obstructive pulmonary disease (COPD) have many additional difficulties to face and conquer. Due to the contribution of avoidable causes of their illness ("smokers' lung"), society holds people with COPD responsible for their disease, which in return often leads to stigmatization and social isolation. In addition, COPD patients commonly belong to a less privileged social class, own a low socioeconomic status, and lower education. Their physical symptoms are easily observable and - by employing moderate adherence - treatable. Nonetheless, the influence of COPD on a patient's psyche often plays an overly prominent role during therapy. "There is only half a patient laying on the examination table," a revelation that sums up the current state of COPD research and the result of the expert meeting "Luftschlösser" ("castles in the clouds"), which took place in spring 2018. Within the limits of the meeting, participants identified practically applicable approaches aiming to enhance the patient management of this challenging patient group. These considerations are supposed to support healthcare professionals in their daily work and aim to improve the therapy as well as the outcome for COPD patients.


COPD management; Integrated care; Stigmatization


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