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

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 ².
• Adjust treatment based on symptoms and exacerbations, considering referral to secondary care for additional therapies such as roflumilast or long-term antibiotics if indicated ¹.
• Offer pulmonary rehabilitation to all appropriate patients, including those recently hospitalized for exacerbations, with programmes tailored to individual needs and accessible locations ¹.
• Ensure patients receive recommended vaccinations, including pneumococcal and annual influenza vaccines ².
• Provide education on COPD symptoms, smoking cessation, avoiding passive smoke, managing breathlessness, physical activity, inhaler technique, and adherence to therapy ².
• Develop and review personalized self-management and exacerbation action plans, including advice on when to use rescue medications and when to seek medical help ¹,².
• Offer short courses of oral corticosteroids and antibiotics for exacerbations if the patient has had recent exacerbations and understands how to use them safely ¹.
• Assess for comorbidities and provide appropriate management, including palliative care options for end-stage COPD ².