COPD Treatment Guidelines

Reviewed by: HU Medical Review Board | Last reviewed: April 2018. | Last updated: March 2023

What are COPD treatment guidelines?

When a person is diagnosed with chronic obstructive pulmonary disease (COPD), the next step is to work with healthcare providers 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 the unique needs of their patient.

The COPD treatment guidelines have four key parts:

  • Identifying and reducing exposure to COPD risk factors
  • Managing stable COPD
  • Managing acute exacerbations, also called COPD flare-ups
  • Monitoring disease progression and follow-ups1

What are the guidelines for identifying and reducing exposure to COPD risk factors?

To help slow down the progress of the disease, healthcare providers advise people with COPD about how they can reduce their exposure to risk factors. The main risk factors are tiny particles in the air, called irritants. For COPD patient, breathing irritants can:

  • Make symptoms worse
  • Increase the risk of COPD flare-ups1

The most important risk factor that people with COPD should avoid is being around tobacco smoke of any kind. This includes smoking, but also includes breathing other people’s tobacco smoke (secondhand smoke). Healthcare providers can offer support and resources to patients to help them quit smoking.

Other risk factors that COPD patients should avoid include:

  • Allergens and irritants in the home and workplace
  • Outdoor air pollution1

What are the treatment guidelines for managing stable COPD?

A person is considered to have stable COPD when their symptoms stay more or less the same on a day-to-day basis. Some days may be better or worse than others, but their disease is under control for the most part. Those who are having a COPD flare-up do not have stable disease, but they may have stable disease again after the flare-up has been treated.

Guidelines for managing stable disease have two goals: reducing symptoms and reducing risk of flare-ups. The goals for managing stable disease include:

  • Relieving everyday symptoms
  • Increasing the patient’s ability to exercise
  • Improving the patient’s 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 complications1

Medications play a large role in the management of stable COPD. People with COPD will often have maintenance medicines that they take every day to help relieve their daily symptoms. They usually have rescue medicines as well, which are on hand to help relieve symptoms that suddenly get worse. Some people also need regular oxygen therapy to help manage their 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, patients learn about many different ways to help control their symptoms, such as:

  • Exercising
  • Nutritional advice
  • Lifestyle changes to help avoid infections
  • Breathing strategies
  • Preparing for emergencies1,2

What are the guidelines for managing COPD flare-ups?

COPD flare-ups happen when a patient’s symptoms suddenly get much worse and cannot be relieved with their regular medications. The most common cause of COPD flare-ups is a respiratory infection. Patients and their healthcare providers can put together an action plan for how to deal with flare-ups. Sometimes, they can be treated at home. In other cases, the flare-up is so severe that it needs to be treated in the hospital.

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

The treatment guidelines recommend people with COPD get vaccinated for influenza (flu) and pnuemonia to prevent these common infections that can cause flares of COPD.1

What are the guidelines for monitoring COPD?

Routine follow-up appointments are essential for managing COPD. During follow-up appointments, patients take breathing tests called spirometry to measure their lung function. Healthcare providers also ask about COPD symptoms, such as cough, sputum (a mixture of saliva and mucus that is coughed up from the lungs), breathlessness, fatigue, activity limitations, and quality of sleep. The frequency and severity of flare-ups will be discussed, as well as exposure to any risk factors, such as smoking. If the doctor notices a significant worsening of symptoms, the individual may get imaging, such as a chest x-ray.1

Follow-up appointments are also a time to discuss medications and how well they are working for the individual with COPD. Any side effects or difficulty taking medications on schedule should be mentioned.1

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