Management

The management of COPD in the UK is based on NICE guidelines, as well as the recommendations and priorities of the Global Initiative for Chronic Obstructive Lung Disease (GOLD), which say community pharmacies should: 

• Offer treatment and support to stop smoking
• Offer pulmonary rehabilitation if appropriate
• Offer pneumococcal and influenza vaccines
• Co-develop a personalised self-management plan
• Optimise treatment for co-morbidities
• Confirm diagnosis using objective measurements (spirometry following short-acting beta-2 agonists (SABA) use (post-bronchodilation))
• Assess airflow limitation FEV1/FVC <0.7 at diagnosis or to confirm diagnosis
• Assess symptom risk of an exacerbation.

It should be noted that asthma and COPD may co-exist in an individual patient. NICE and GOLD both emphasise that while they may share some common traits and clinical features, these are different disorders. If a concurrent diagnosis of asthma is suspected, pharmacotherapy should primarily follow asthma guidelines, but pharmacological and non-pharmacological approaches may also be needed for the COPD. This module will concentrate on the non-pharmacological approaches.