[Management of patients with chronic obstructive pulmonary disease in routine clinical practice]

Chronic obstructive pulmonary disease (COPD) is among the leading causes of death worldwide and is characterized by chronic respiratory symptoms, persistent airflow limitation, and exacerbations. Diagnosis is confirmed by post-bronchodilator spirometry. Effective long-term management requires a structured assessment of relevant exposures, symptom burden, exacerbation history, and comorbidities. Key goals of treatment include reducing both symptom and disease burden and preventing future exacerbations, which are often associated with increased lung function decline. This article summarizes practical concepts for diagnostic work-up and therapeutic decision-making at the time of diagnosis, during follow-up, in acute exacerbations, and in the context of palliative care. It highlights individualized inhaled therapy, guided by symptoms, exacerbations, and blood eosinophil counts, as well as evidence-based non-pharmacological interventions such as smoking cessation, pulmonary rehabilitation, long-term oxygen therapy/non-invasive ventilation, and lung volume reduction strategies.