For a patient with newly diagnosed COPD, begin by explaining the condition and its symptoms to the patient. NICE NG115
Advise and encourage smoking cessation at every opportunity, offering help such as nicotine replacement therapy, varenicline, or bupropion, combined with support programmes. NICE NG115
Recommend avoiding passive smoke exposure. NICE NG115
Manage breathlessness initially with short-acting bronchodilators, such as SABA or SAMA, used as necessary. NICE NG115
Offer inhaled therapy based on symptom severity and exacerbation risk, starting with a long-acting bronchodilator (LABA or LAMA), preferably a long-acting agent if appropriate. NICE NG115
For patients with persistent symptoms or exacerbations, escalate treatment to a combination of LABA and LAMA, and consider adding inhaled corticosteroids (ICS) if blood eosinophil count exceeds 300 cells/microlitre. NICE NG115,NICE CKS
Advise vaccination against influenza and pneumococcus to reduce respiratory infections. NICE NG115
Encourage participation in pulmonary rehabilitation to improve symptoms, exercise tolerance, and quality of life. NICE NG115
Discuss the importance of medication adherence and correct inhaler technique. NICE NG115
Provide lifestyle advice on increasing physical activity, diet, and avoiding air pollution. NICE NG115
Develop a personalized self-management and exacerbation action plan, including when to use short courses of oral corticosteroids and antibiotics for exacerbations. NICE NG115