What follow-up actions should I take for patients with confirmed COPD based on spirometry findings?

For patients with confirmed chronic obstructive pulmonary disease (COPD) based on spirometry findings, follow-up actions should include:

• Regular monitoring of disease progression using spirometry to assess lung function over time.
• Assessment and grading of breathlessness using the Medical Research Council (MRC) dyspnoea scale to guide management.
• Comprehensive clinical review including evaluation of symptoms such as weight loss, exercise tolerance, fatigue, and any signs that may suggest alternative diagnoses or complications.
• Additional investigations at diagnosis such as chest radiograph, full blood count, and body mass index (BMI) calculation to exclude other pathologies and identify comorbidities.
• Referral for specialist advice when clinically indicated, including diagnostic uncertainty, suspected severe COPD, rapid decline in lung function, onset of cor pulmonale, or consideration for pulmonary rehabilitation and oxygen therapy.
• Discussion and review of medication use at all appointments, particularly corticosteroids and antibiotics, ensuring patients understand their use and investigating frequent exacerbations.
• Encouragement of self-management with an action plan for exacerbations, including adjusting bronchodilator therapy, use of oral corticosteroids and antibiotics as appropriate, and prompt communication with healthcare professionals.
• Consideration of psychological support such as cognitive behavioural therapy for patients experiencing frightening breathlessness to help manage anxiety.
• Education about the disease course and management including smoking cessation advice if relevant, and information on what to expect in case of hospitalisation.

These follow-up actions aim to optimise therapy, monitor disease progression, manage exacerbations promptly, and improve quality of life for people with COPD ¹.