The Canadian Thoracic Society Recommendations for Management of Chronic Obstructive Pulmonary Disease: Implications for Physiotherapists

Purpose: The purposes of this article are (1) to list key messages from the 2003 chronic obstructive pulmonary disease (COPD) guidelines of the Canadian Thoracic Society (CTS) and associated implications and responsibilities for physiotherapists and (2) to compare these guidelines with other published reports or statements describing pulmonary rehabilitation. Summary of Key Points: The main responsibilities that physiotherapists should assume to optimize prevention of COPD and management of persons with COPD are to (1) recommend and support smoking cessation for all patients who are smokers; (2) prescribe exercise programmes for patients with COPD; (3) ensure that people with COPD resume activity after an acute exacerbation; (4) refer patients to physicians for appropriate evaluation and care if not yet diagnosed with COPD or if the management of the patient's symptoms is not optimal or consistent with the COPD guidelines developed by the CTS; (5) facilitate adherence to pharmacotherapy; (6) participate actively in ongoing evaluation and education about all aspects of care for patients with COPD and their caregivers; and (7) support patients with COPD and their caregivers with end-of-life issues. Conclusions: Physiotherapists, as direct access practitioners or members of a multidisciplinary team, should play a major role in the health care of persons with COPD, a serious health condition that affects 4% of adult Canadians.