COPD Treatment Guidelines

Reviewed by: HU Medical Review Board | Last reviewed: May 2023

If you are diagnosed with chronic obstructive pulmonary disease (COPD), the next step is to work with your doctor to create an individualized COPD treatment plan. Experts have developed a set of COPD treatment guidelines, based on years of research, which offer advice about the best ways to treat COPD. Doctors take the guidelines into consideration and create a treatment plan that is best for your unique needs.

The COPD treatment guidelines have 4 key parts:1

  • Identifying and reducing exposure to COPD risk factors
  • Managing stable COPD
  • Managing acute exacerbations, also called COPD flare-ups
  • Monitoring disease progression and follow-ups

Guidelines for identifying and reducing exposure to COPD risk factors

To help slow down the progress of the disease, your doctor will talk to you about ways to reduce your exposure to risk factors. The main risk factors are tiny particles in the air, called irritants. For people with COPD, breathing irritants can:1

  • Make symptoms worse
  • Increase the risk of COPD flare-ups

The most important risk factor you should avoid is being around tobacco smoke of any kind. This includes smoking but also includes breathing other people’s tobacco smoke (secondhand smoke). If you smoke, talk to your doctor about support and resources to help you quit smoking.1

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Other risk factors you should avoid include:1

  • Allergens and irritants in the home and workplace
  • Outdoor air pollution

Treatment guidelines for managing stable COPD

You are considered to have stable COPD when your symptoms stay more or less the same on a day-to-day basis. Some days may be better or worse than others, but your disease is under control for the most part. If you are having a COPD flare-up, you are not considered to have stable disease. But you may have stable disease again after your flare-up has been treated.

Guidelines for managing stable disease have 2 goals:1

  • Reducing symptoms
  • Reducing the risk of flare-ups

The goals for managing stable disease include:1

  • Relieving everyday symptoms
  • Increasing the ability to exercise
  • Improving overall health
  • Slowing the progress of the disease as much as possible
  • Preventing and treating COPD flare-ups
  • Reducing the risk of serious and/or life-threatening complications

Medicines play a large role in the management of stable COPD. Your doctor will likely prescribe you maintenance medicines to take each day to help relieve your daily symptoms. You will also likely have rescue medicines, which are used to relieve symptoms that suddenly get worse. You may also need regular oxygen therapy to help manage your stable COPD.1

People with COPD are strongly encouraged to take part in a pulmonary rehabilitation program to help them manage their stable disease. During these programs, you learn about many different ways to help control their symptoms, such as:1,2

  • Exercising
  • Nutritional advice
  • Lifestyle changes to help avoid infections
  • Breathing strategies
  • Preparing for emergencies

Guidelines for managing COPD flare-ups

COPD flare-ups happen when symptoms suddenly get much worse and cannot be relieved with regular medicines. The most common cause of COPD flare-ups is a respiratory infection. You and your doctor can work together to create an action plan on how to deal with flare-ups. Sometimes, flare-ups can be treated at home. In other cases, the flare-up is so severe that it needs to be treated in the hospital.1

If your flare-up is caused by a bacterial infection, it will usually be treated with antibiotics. Rescue inhalers and nebulizer treatments are often used to help relieve severe breathlessness. In some cases, you may need to be treated with short-term steroids or oxygen therapy.1

The treatment guidelines also recommend people with COPD get vaccinated for influenza (flu), pneumonia, and COVID-19 to prevent these common infections that can cause flares of COPD.1,3

Guidelines for monitoring COPD

Routine follow-up appointments are essential for managing COPD. During follow-up appointments, your doctor will have you take breathing tests to measure your lung function.1

Your doctor will ask you about your COPD symptoms, such as:1

  • Cough
  • Sputum (a mixture of saliva and mucus that is coughed up from the lungs)
  • Breathlessness
  • Fatigue
  • Activity limitations
  • How well you are sleeping

Your doctor will also ask you about how often you have flare-ups and how severe they are. They will talk to you about your exposure to any risk factors, such as smoking. If your doctor notices your symptoms have worsened, you may need a chest X-ray.1

Follow-up appointments are also a time to talk to your doctor about your COPD medicines and how well they are working. Tell your doctor if you are having any side effects or trouble taking your medicines as prescribed.1