COPD Specialist Consultation for Physicians
The following are criteria that are helpful when determining if your patient may benefit from a consultation with a pulmonologist:
- Confirmation of the diagnosis of COPD when presenting features are atypical
- Exclusion of other pulmonary disorders
- A suspicious chest X-ray
- Management of patients not responding to seemingly appropriate therapy
- Management of patients with increasing or worsening symptoms
- Consideration of surgical therapy for emphysema
- Severe disease, including persistent dyspnea with activities of daily living despite adequate therapy, or frequent recurrent exacerbations
- Evaluation for initiation of oxygen therapy; continuous or nocturnal
- Consideration for trans-tracheal oxygen
- Unremitting purulent sputum
- Persistent pulmonary infiltrates
- Suspected sleep disturbance
Additional Indications for Further Evaluation of COPD
- Greater than one hospitalization in one year, two ER visits or three unscheduled PCP office visits, for exacerbations
- Progression of functional impairment despite seemingly adequate therapy
- Poor adherence to the prescribed regimen
- Multi-system disease
- Rapid and/or progressive worsening of (especially irreversible) airways obstruction
- Chronic respiratory failure
Additional Indications for Specialist Referral for COPD Patients
- Work related symptoms (Environmental Medicine Physician)
- Seasonal variation in symptoms and/or a history of atopy (Allergist)
- Excessive nasal and/or sinus symptoms (ENT Physician)
- Signs of depression or other mental illness (Psychiatrist)
- Signs or symptoms of cardiac disease, cor pulmonale or other (Cardiologist)
