CHRONIC OBSTRUCTIVE PULMONARY DISEASE IN PRIMARY HEALTH CARE: CHALLENGES FOR DIAGNOSIS, CLINICAL MANAGEMENT AND CONTINUITY OF CARE

Abstract

Chronic Obstructive Pulmonary Disease is an important public health problem associated with a high burden of morbidity, mortality, functional disability, and health service utilization. This chapter aims to analyze the role of Primary Health Care in early recognition, diagnosis, clinical management, and continuity of care for people with COPD, emphasizing the challenges found within the Brazilian Unified Health System. This is a narrative review based on national and international technical and scientific documents and literature addressing epidemiology, diagnosis, treatment, and organization of care. The analysis shows that underdiagnosis remains a major obstacle, particularly because respiratory symptoms are often normalized, access to spirometry is limited, and care is fragmented across health care settings. Appropriate management requires combining pharmacological treatment with nonpharmacological interventions, including smoking cessation, vaccination, physical activity, health education, inhaler technique assessment, and prevention of exacerbations. The management of multimorbidity and coordination among Primary Health Care, specialized care, pulmonary rehabilitation, and emergency services are also essential. It is concluded that improving care depends on expanding diagnostic capacity, continuing professional education, adopting updated clinical protocols, and strengthening care coordination. Effective Primary Health Care can reduce diagnostic delays, complications, and avoidable hospitalizations while promoting comprehensive and longitudinal care for people living with COPD.