A person-centred clinical approach to the multimorbid patient with COPD

Most patients with a chronic disease are multimorbid. This is particularly important in patients with chronic obstructive pulmonary disease (COPD), who on average have five other identified comorbidities that independently impact their health and increase their mortality risk. Using a modified Delphi method, we selected the 20 most important diseases associated with COPD and clustered them into five domains: mental, respiratory, cardiovascular, metabolic and multiple organs loss of tissue. We then developed a systematic approach to characterise the impact and clinical presentation of individual diseases within each cluster, and to define the priority and timing of measurement of the potential markers of disease presence and severity. Given the absence of integrated guidelines to treat multimorbid patients, we reviewed and selected individual disease guidelines or recommendations that can be accessed for specific information related to the management of each disease. In addition, we built a multimorbidity 'Health Dashboard' that, completed by the patient or health practitioner, can help identify the presence and severity of comorbid diseases. By using a practical comprehensive approach, it is possible to identify and characterise important comorbid diseases in patients with COPD, and to implement management tools that should help improve their outcome. This expert consensus commentary summarises patient-centred recommendations to manage comorbidities in COPD patients, aiming to improve quality-of-life and reduce disease burden through a holistic approach. Prospective pragmatic trials comparing such an approach with usual care for multimorbid patients with COPD including long-term follow-up are urgently needed.

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Publication Details

Journal
European Journal of Internal Medicine
Published
2025-08-12
DOI
https://doi.org/10.1016/j.ejim.2025.07.020
Citations
11
Primary Topic
Chronic Obstructive Pulmonary Disease (COPD) Research
Type
article
Field-Weighted Citation Impact
16.70

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article

A person-centred clinical approach to the multimorbid patient with COPD

Leonardo Pantoni, Daiana Stolz, Bartolomé R. Celli, Gerard J. Criner et al.
11 citations
European Journal of Internal Medicine
Chronic Obstructive Pulmonary Disease (COPD) Research
16.70
article

A person-centred clinical approach to the multimorbid patient with COPD

Leonardo Pantoni, Daiana Stolz, Bartolomé R. Celli, Gerard J. Criner, Leonardo Michele Fabbri, Alberto Papi, Jennifer Kathleen Quint, Nathaniel M. Hawkins, Abebaw Mengistu Yohannes, Christine Jenkins, Alvar G.N. Agustí, Sanjay Sethi, Marc Humbert, Jessica M. Bon, Don D. Sin
article en
11 citations

Abstract

Most patients with a chronic disease are multimorbid. This is particularly important in patients with chronic obstructive pulmonary disease (COPD), who on average have five other identified comorbidities that independently impact their health and increase their mortality risk. Using a modified Delphi method, we selected the 20 most important diseases associated with COPD and clustered them into five domains: mental, respiratory, cardiovascular, metabolic and multiple organs loss of tissue. We then developed a systematic approach to characterise the impact and clinical presentation of individual diseases within each cluster, and to define the priority and timing of measurement of the potential markers of disease presence and severity. Given the absence of integrated guidelines to treat multimorbid patients, we reviewed and selected individual disease guidelines or recommendations that can be accessed for specific information related to the management of each disease. In addition, we built a multimorbidity 'Health Dashboard' that, completed by the patient or health practitioner, can help identify the presence and severity of comorbid diseases. By using a practical comprehensive approach, it is possible to identify and characterise important comorbid diseases in patients with COPD, and to implement management tools that should help improve their outcome. This expert consensus commentary summarises patient-centred recommendations to manage comorbidities in COPD patients, aiming to improve quality-of-life and reduce disease burden through a holistic approach. Prospective pragmatic trials comparing such an approach with usual care for multimorbid patients with COPD including long-term follow-up are urgently needed.

European Journal of Internal MedicineVol. 140
Brigham and Women's Hospital (US), University of British Columbia (CA), University of Freiburg (DE), University of Milan (IT), University of Ferrara (IT), Université Paris-Saclay (FR), University of Alabama at Birmingham (US), Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (ES), The George Institute for Global Health (AU), Casa di Cura Columbus (IT), St. Paul's Hospital (CA), Fundació Clínic per a la Recerca Biomèdica (ES), Bicêtre Hospital (FR), Wake Forest University (US), Imperial College London (GB), University at Buffalo, State University of New York (US), Temple University (US)
Amgen, Pulmonary Fibrosis Foundation, Eli Lilly and Company, Pfizer, AstraZeneca, Bayer, GlaxoSmithKline, Sanofi, Massachusetts General Hospital, Gilead Sciences, Patient-Centered Outcomes Research Institute, United Therapeutics Corporation, Chiesi Farmaceutici, COPD Foundation, CSL Behring, Regeneron Pharmaceuticals, Intuitive Surgical, Cerecor, Amicus Therapeutics, ResMed, Incyte, Veracyte, NGM Biopharmaceuticals, Moderna, Galápagos, Insmed, National Institute for Health and Care Research, Lung Foundation Australia, Swedish Orphan Biovitrum, AOP Orphan, Mereo BioPharma, Genentech, Novartis Pharma, Medical Research Council, National Heart, Lung, and Blood Institute
Good health and well-being
Openalex Percentile: Top 1%
Chronic Obstructive Pulmonary Disease (COPD) Research
16.70
DOIOpen Access PDFOpenAlex
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