Chronic obstructive pulmonary disease: Management guidelines

• The key recommendations for the management of COPD are summarised by the acronym COPDX: Confirm diagnosis, Optimise function, Prevent deterioration, Develop a support network and self-management plan, and mariage eXacerbations. • Spirometry is the gold standard for diagnosis, severity assessment and monitoring of COPD. • The core symptoms (cough, sputum production and dyspnoea) are controlled by pulmonary rehabilitation and efficacious medication (bronchodilators, inhaled glucocorticoids and antibiotics, plus oxygen therapy where there is hypoxaemia). • Deterioration is prevented by reducing risk factors (stopping cigarette smoking, the most significant risk factor for COPD) and reducing infections and exacerbations. • COPD impacts on both patients and carers - a multidisciplinary support team, self-management plans and support groups help patients and carers to cope. • Early diagnosis and treatment of exacerbations may prevent progressive functional decline and hospital admission. Prompt and appropriate referral optimises patient outcomes.