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ModerateRespiratoryStable COPD managementuk-plab-1

A 62-year-old man with COPD (FEV1 55% predicted) is reviewed in GP clinic. He is an ex-smoker with no history of asthma or atopy. He uses a Salbutamol inhaler several times a day and remains breathless on exertion but has had only one mild exacerbation in the last year. What is the most appropriate next step in his inhaled maintenance therapy?

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