Improving the diagnosis and management of COPD

COPD is a progressive condition. Therefore, earlier diagnosis allows earlier intervention in particular smoking cessation. Stopping smoking in early middle age where an individual has relatively mild COPD is associated with a slower decline in lung function and reduced mortality. Spirometry should be performed in symptomatic current or former smokers (typically ≥ 10 pack years) who are aged at least 35 where COPD is a likely differential diagnosis. Once airflow obstruction is proven and a diagnosis of COPD established then a measure of COPD severity can be made based on FEV1 expressed as a percentage of predicted value. When an individual with COPD is assessed it is vital that comorbid conditions are considered and management optimised. Cardiovascular disease and diabetes were seen most commonly in people enrolled in the active and sometimes sleep. The COPD Assessment Tool is a simple measure of health status that takes under five minutes to complete. Performing spirometry each year can identify patients with a rapid, progressive decline in lung function and allow this to be addressed. Inhaler technique should be checked at this review and also when a new type of inhaler is commenced.