Management of COPD

Management for Patients

The guidelines set by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) state that management of COPD includes assessing and monitoring the disease, reducing risk factors, managing stable COPD and managing Exacerbations. ¹²

Preventive Measures

Smoking Cessation

The single most important first step a person diagnosed with or at risk for COPD to take is to quit smoking. This is true regardless of the duration or severity of the COPD. Persistent cigarette smoking not only accelerates the disease process but also defeats the effect of established therapies. Smoking cessation is the only preventive measure that can improve disease survival in COPD. For more information, please visit the section on Smoking Cessation or call the Respiratory Health Association of Metropolitan Chicago at 1-800-880-LUNG.

Avoid Infection

People living with COPD are particulary at risk for respiratory infections, which are generally severe, and therefore make them prone to complications. Avoiding infections and treating them quickly are both important components of COPD therapy.

All patients with COPD should receive an annual flu shot in advance of flu season. Studies have shown that annual Influenza immunization is 76% effective in reducing the number of patients with COPD who get the flu.103 For patients who get the flu, antiviral medications may be prescribed. Patients with COPD should also have a pneumococcal vaccination (Pneumovax®) every 5 years.34

Antibiotics have no role in the routine management of COPD but have proven beneficial in patients with worsening symptoms they have a respiratory infection or exacerbation.

Other Important Preventive Measures

• Avoid smoking (not only cigarettes but pipes, cigars, marijuana or any other smoking substance.

• Avoid second hand smoke

• Avoid occupational dusts and/or chemicals

• Avoid indoor and outdoor air pollution (to learn more about the effects of air pollution, visit the section on air pollution.

• Maintain an ideal body weight, good physical condition, and good nutritional status

• Visit your doctor regularly

Therapy with Medications

Most people with COPD take medications on a regular basis to decrease breathing difficulty. Other medications are used only on an as needed basis to decrease shortness of breath.

Medications generally prescribed for people with COPD fall into one of three groups:

• bronchodilators, which are usually inhalers designed to open up the patient’s airways and help in making breathing easier
• Steroids, to reduce Inflammation in the airways

   

• antibiotics, to treat infections

To learn more about each type of medication, visit the section on Medications for COPD Patients.

Oxygen Therapy

Long term oxygen therapy (> 15 hours per day_ is generally introduced in patients that have severe COPD or low oxygen in their blood stream. It is important to work with your healthcare provider to determine if oxygen therapy is appropriate for you. Oxygen therapy has not only been shown to improve exercise capability, sleep, and cognitive performance, but also decreases the risk of death for patients with chronic respiratory failure.

For more information visit the section on oxygen therapy or visit the National Home Oxygen Patients Association website at www.homeoxygen.org.

Pulmonary Rehabilitation

Pulmonary Rehabilitation has been redefined by the American Thoracic Society as a “multidisciplinary program of care for patients with chronic respiratory impairment that is individually tailored and designed to optimize physical and social performance and autonomy.”72

The goal of pulmonary rehabilitation is to reduce symptoms, improve quality of life and increase physical and emotional participation in daily activities of life. Pulmonary rehabilitation has been shown to improve shortness of breath, improve quality of life scores and reduce the number of hospitalizations and days in the hospital.