Tratamiento de pacientes con enfermedad pulmonar obstructiva crónica (EPOC) por médicos clínicos generales

a number of recommendations for the treatment of chronic obstructive pulmonary disease (copd) present the different therapeutic alternatives according to the severity of the condition. it is not entirely clear when the generalist should consult the specialist. this can be important particularly when the health care system is centered in the role of generalists and lack of clarity may be a factor in the deficient use of recommendations. the purpose of this review is to provide evidence of the efficacy and effectiveness for therapeutic approaches distilling from randomized controlled trials, observational trials and guidelines or meta-analyses. the emphasis is on the identification of clinical and physiological criteria that generalists should use to identify candidates for possible consultation with specialists.