[On the Basis of a Case: Follow-Up of a Patient with Chronic Obstructive Pulmonary Disease (COPD) through the EPOCA Service]

【病例分析:通过EPOCA服务对一名慢性阻塞性肺疾病(COPD)患者进行随访】

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Abstract

71-year-old man with multiple pathologies. He goes to the pharmacy and a frequent throat clearing and cough is detected. He says it has been going on for a couple of months. He has tried mucolytics, cough suppressants and flu medications, and nothing calms him down. As a patient with COPD, you are invited to go to the PCA.During the initial consultation, we provided health education and a spirometry test with the Vitalograph® COPD-6 (unable). We performed validated tests, reviewed the inhalation technique, device care, and cleaning, as well as the patient's medications.The patient was instructed on proper inhalation technique, as two critical errors were detected.After 6 days, he was given an appointment and the same tests were performed, obtaining acceptable FEV1/FEV6 values, COPD grade = 2, BODEX = 3 (moderate), and corrected inhalation technique, but he did not improve his sintoms.After 7 days, we performed spirometry again, COPD grade = 1, BODEX = 3. The technique still showed no critical errors, so we used the InCheckDial® to detect whether the inspiratory flow was correct, and we detected that the inspiration was too forceful (≥90 L/min).The patient was referred to the PCP for treatment assessment with a detailed report suggesting a change of inhalation device. The PCP changed the device to an Ellipta® and requested a follow-up with your pulmonologist.

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