Canadian Respiratory Journal

Canadian Respiratory Journal / 2003 / Article

Executive Summary | Open Access

Volume 10 |Article ID 567598 |

Denis E O’donnell, Shawn Aaron, Jean Bourbeau, Paul Hernandez, Darcy D Marciniuk, Meyer Balter, Gordon Ford, Andre Gervais, Roger Goldstein, Rick Hodder, Francois Maltais, Jeremy Road, "Canadian Thoracic Society Recommendations for Management of Chronic Obstructive Pulmonary Disease – 2003", Canadian Respiratory Journal, vol. 10, Article ID 567598, 23 pages, 2003.

Canadian Thoracic Society Recommendations for Management of Chronic Obstructive Pulmonary Disease – 2003


Chronic obstructive pulmonary disease (COPD) is a common cause of disability and death in Canada. Moreover, morbidity and mortality from COPD continue to rise and the economic burden is enormous. The main goal of the Canadian Thoracic Society (CTS) Evidence-Based Guidelines is to optimize early diagnosis, prevention and management of COPD in Canada. Targeted spirometry is strongly recommended to expedite early diagnosis in smokers and exsmokers who develop respiratory symptoms, and who are at risk for COPD. Smoking cessation remains the single most effective intervention to reduce the risk of COPD and to slow its progression. Education, especially self-management plans, are key interventions in COPD. Therapy should be escalated in accordance with the increasing severity of symptoms and disability. Long acting anticholinergics and beta2-agonist inhalers should be prescribed for patients who remain symptomatic despite short-acting bronchodilator therapy. Inhaled steroids should not be used as first line therapy in COPD, but have a role in preventing exacerbations in patients with more advanced disease who suffer recurrent exacerbations. Management strategies consisting of combined modern pharmacotherapy and nonpharmacotherapeutic interventions (eg, pulmonary rehabilitation/exercise training) can effectively improve symptoms, activity levels, and quality of life, even in patients with severe COPD. Acute exacerbations of COPD cause significant morbidity and mortality and should be treated promptly with bronchodilators and a short course of oral steroids; antibiotics should be prescribed for purulent exacerbations. Patients with advanced COPD and respiratory failure require a comprehensive management plan that incorporates structured end-of-life care.

Copyright © 2003 Canadian Thoracic Society. This open-access article is distributed under the terms of the Creative Commons Attribution Non-Commercial License (CC BY-NC) (, which permits reuse, distribution and reproduction of the article, provided that the original work is properly cited and the reuse is restricted to noncommercial purposes.

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