What are the best practices for managing patients with chronic obstruc

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Manage COPD in a general practice setting by:

Performing spirometry at diagnosis, to confirm the diagnosis and monitor disease progression, and reconsidering diagnosis if symptoms are atypical .
Adjust treatment based on symptoms and exacerbations, considering referral to secondary care for additional therapies such as roflumilast or long-term antibiotics if indicated .
Offer pulmonary rehabilitation to all appropriate patients, including those recently hospitalized for exacerbations, with programmes tailored to individual needs and accessible locations .
Ensure patients receive recommended vaccinations, including pneumococcal and annual influenza vaccines .
Provide education on COPD symptoms, smoking cessation, avoiding passive smoke, managing breathlessness, physical activity, inhaler technique, and adherence to therapy .
Develop and review personalized self-management and exacerbation action plans, including advice on when to use rescue medications and when to seek medical help ,.
Offer short courses of oral corticosteroids and antibiotics for exacerbations if the patient has had recent exacerbations and understands how to use them safely .
Assess for comorbidities and provide appropriate management, including palliative care options for end-stage COPD .

What are the best practices for managing patients with chronic obstructive pulmonary disease (COPD) in a general practice setting?