Friday, December 8, 2023
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Chair
Family Physician Airways Group of Canada
Immediate Past-Chairperson
Respiratory Medicine Special Interest Focus Group
College of Family Physicians of Canada
Vice President
Respiratory Effectiveness Group
Toronto, Ontario, Canada
This activity has been peer reviewed and the reviewer has disclosed no relevant financial relationships.
This educational activity is intended for an international audience of non-US primary care providers, pulmonologists, and allergists/clinical immunologists.
The goal of this activity is to improve decision making about chronic obstructive pulmonary disease (COPD) based on practical cases of COPD presenting in primary care.
Upon completion of this activity, participants will:
WebMD Global requires each individual who is in a position to control the content of one of its educational activities to disclose any relevant financial relationships occurring within the past 12 months that could create a conflict of interest.
Chair
Family Physician Airways Group of Canada
Immediate Past-Chairperson
Respiratory Medicine Special Interest Focus Group
College of Family Physicians of Canada
Vice President
Respiratory Effectiveness Group
Toronto, Ontario, Canada
This activity has been peer reviewed and the reviewer has disclosed no relevant financial relationships.
The Faculty of Pharmaceutical Medicine of the Royal Colleges of Physicians of the United Kingdom (FPM) has reviewed and approved the content of this educational activity and allocated it 1.0 continuing professional development credits (CPD).
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CPD Released: 4/22/2021
Valid for credit through: 4/22/2022, 11:59 PM EST
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Note: The information on the coronavirus outbreak is continually evolving. The content within this activity serves as a historical reference to the information that was available at the time of this publication. We continue to add to the collection of activities on this subject as new information becomes available. In order to facilitate disseminating this educational activity as quickly as possible, the associated slides will be included 1-2 weeks after the activity posting date.
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Joanne is a 52-year-old account executive who has been smoking since the age of 18. She has hypertension and a history of gastroesophageal reflux disease (GERD). She was diagnosed with asthma 3 months ago and started on a dry powder inhaler (DPI) with a combination of formoterol, a long-acting beta-agonist (LABA), and budesonide, an inhaled corticosteroid (ICS). However, she is still symptomatic. During a telemedicine visit with her general practitioner (GP), she reports that she coughs almost all the time, produces a lot of phlegm, and often wakes up in the middle of the night because of coughing. She also mentions that she is often breathless after climbing stairs and does not go out very often because of her symptoms. When asked about her medication, she complains that she has trouble using the DPI.
Based on her symptoms, the GP suspects that Joanne has chronic obstructive pulmonary disease (COPD), not asthma, and he recommends that Joanne comes to the office for spirometry. Spirometry has only recently resumed, on a limited basis, because the procedure generates aerosols and increases the risk of transmitting COVID-19. However, the GP notes that spirometry is urgent and essential to make a correct diagnosis for Joanne, in line with recent guidance. At her appointment, Joanne's spirometry readings reveal that her forced expiratory volume in 1 second (FEV1) is 1.93 L, or 55% predicted; her forced vital capacity (FVC) is 3.50 L; and her FEV1/FVC ratio is 0.55, which is below the lower limit of normal (LLN) of 70%, with no change post-bronchodilator and with her budesonide/formoterol held for 48 hours.
