Feature Article

Chronic obstructive pulmonary disease: management guidelines

Peter Frith, David McKenzie



The latest guidelines for managing COPD are summarised. Spirometry is the gold standard for diagnosis, assessment and monitoring. Smoking cessation, vaccinations, bronchodilators, glucocorticoids and pulmonary rehabilitation are the usual interventions, although antibiotics and oxygen therapy may also be required.

Key Points

  • 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 manage 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.