We dedicate this monograph to the late Thomas A. Neff (1937 to 1994), our beloved colleague. Tom was a consummate physician, a great husband and father, and a tremendous human being. We shall always be enriched by his memory.

Preface

The first edition of Frontline Treatment of COPD has reached more than 100,000 frontline practitioners. This monograph has been used extensively in postgraduate education programs for internists, family practitioners, nurse practitioners, physicians’ assistants, pharmacists, clinic and office nurses, and respiratory therapists. Frontline Treatment of COPD has been the subject of Grand Rounds in several university hospitals and many community hospitals around the Country. Many of the authors of the first edition have participated in these continuing medical education programs.

In conjunction with Medical Education Resources, fall programs held on Saturday mornings have been well attended, and the program, based upon this monograph has been extremely well received. The sponsors have also produced a two hour audio tape that carries the major messages of this monograph.

This monograph was first published in 1996. In view of significant advances in our understanding of the patho-genesis of COPD, new developments in pharmacological management and experimental surgical approaches, it became necessary to produce a second edition. A new national healthcare initiative, the National Lung Health Education Program, (NLHEP), aims to involve all primary care practitioners in the early identification and intervention in COPD. Section M of this second edition describes the NLHEP and its goals and objectives.

In the past, we learned to treat acute respiratory failure, to improve the quality and length of life with ambulatory oxygen therapy, and to increase the horizons of patients suffering advanced respiratory insufficiency through the development of pulmonary rehabilitation programs. Now it is time to take a hard look at preventing the progress of COPD when it is diagnosed in early and often asymptomatic stages.

The Editor