Internal Medicine detects up to 79 comorbidities associated with COPD, and this has been revealed in the 16th meeting of Chronic Obstructive Pulmonary Disease of the Spanish Society of Internal Medicine (SEMI) recently organized in Madrid. The news of the GOLD 2023 Guidelines and the book ‘Comorbidities in COPD’ were also presented at the meeting.
COPD in Internal Medicine
The most common profile of the COPD patient in Internal Medicine is that of an elderly man, smoker or ex-smoker, with various comorbidities and polypharmacy, as reported by SEMI. More than half of the discharges due to exacerbation of COPD in Spain are made from the Internal Medicine services. Besides, more and more women diagnosed with COPD are admitted. On the contrary, the less frequent profile in Internal Medicine is that of a “young patient (less than 50 years of age), non-smoker and with hardly any comorbidities”.
Personalized medicine
Specialists have spoken of the need to develop personalized medicine to treat patients with COPD, “a chronic, complex and heterogeneous disease”, as they have defined it. For this reason, it is necessary to know the comorbidities associated with COPD when patients are admitted, not only on an outpatient basis.
Comorbidities associated with COPD
Depression and anxiety are “extremely frequent” pathologies, especially in advanced stages of the disease. SEMI estimates that more than 50 percent of COPD patients have one of these mental health disorders. Other frequent associated comorbidities are malnutrition, erectile dysfunction, sleep disorders, periodontitis and oral disorders.
It should be remembered that the average underdiagnosis of COPD in Spain is greater than 80%, and that the prevalence among the population between 40 and 80 years of age is 11.8%.
Pharmacological and non-pharmacological treatment
Regarding treatment, experts have pointed out that beta-lactam antibiotics, quinolones, and carbapenems are the most widely used groups in COPD.
The internist must adjust drug treatment in stable phase (double and triple non-bronchodilator therapy). Likewise, he can advise the patient regarding non-pharmacological therapies, such as rehabilitation-respiratory physiotherapy or the nutritional approach.
“Internists play a fundamental role in the care of patients with COPD, especially in advanced stages,” the specialists have indicated. By way of conclusion, they have pointed out among their functions that they should have a more active role, especially in the search for comorbidities and their treatment.