European Respiratory Society Monograph, Vol. 38. 2006
Since the 1970s, therapeutic nihilism has moved towards a more optimistic attitude regarding therapeutic alternatives in COPD. Research focused on inflammatory and physiological mechanisms has substantially increased during the last 10 years. This has led to an increased understanding of the pathophysiology of the disease, which has resulted in improved treatment. Thus, in parallel to smoking-cessation programmes, other treatment modalities have been shown to be successful. Physiotherapy and pharmacotherapy have been extensively studied and the knowledge regarding what these therapeutic approaches can offer is constantly growing. The importance of nutritional aspects and adjustment in daily life activities have made dieticians and occupational therapists important members of the treatment team. Vaccination programmes, treatment of infections and lung volume reduction surgery are other therapeutic alternatives that have contributed to the improved care of COPD patients.