This site is intended for healthcare professionals

CPD
CPD
Pro
Pro
Sign in
Go to /sign-in page

You can view 5 more pages before signing in

Go to /pro/cpd-dashboard page

This page is worth 0.05 CPD credits. CPD dashboard

Go to /account/subscription-details page

This page is worth 0.05 CPD credits. Upgrade to Pro

Follow-up of COPD in primary care

Authoring team

Patients with mild/moderate/severe (stages 1 to 3) COPD:

  • should be reviewed at least once per year, or more frequently if indicated
  • review should cover the following issues
    • smoking status and desire to quit
    • adequacy of symptom control - breathlessness, exercise tolerance, estimated exacerbation frequency
    • presence of complications
    • effects of each drug treatment
    • inhaler technique
    • need for referral to specialist and therapy services
    • need for pulmonary rehabilitation
    • measurement of - FEV1 and FVC, BMI, MRC dyspnoea score

Patients with very severe (stage 4) COPD:

  • should be seen at least twice a year
  • specific attention should be paid to the following issues
    • smoking status and desire to quit
    • adequacy of symptom control - breathlessness, exercise tolerance, estimated exacerbation frequency o presence of cor pulmonale
    • need for long-term oxygen therapy
    • patient's nutritional state
    • presence of depression
    • effects of each drug treatment
    • inhaler technique
    • need for referral to specialist and therapy services
    • need for pulmonary rehabilitation
    • measurement of - FEV1 and FVC, BMI, MRC dyspnoea score, SaO2

Notes:

Post-bronchodilator FEV1/FVC

FEV1 % predicted

Severity of airflow obstruction

Using NICE clinical guideline 12 (2004)

Severity of airflow obstruction

Using ATS/ERS 2004

Severity of airflow obstruction

Using GOLD 2024

Severity of airflow obstruction

Using NICE clinical guideline 101 (2010)

Post-bronchodilator

Post-bronchodilator

Post-bronchodilator

< 0.7

>80%

Mild

Stage 1 - Mild Stage

Stage 1 - Mild*

< 0.7

50-79%

Mild

Moderate

Stage 2 - Moderate

Stage 2 - Moderate

< 0.7

30-49%

Moderate

Severe

Stage 3 - Severe

Stage 3 - Severe

< 0.7

< 30%

Severe

Very severe

Stage 4 - Very severe

Stage 4 - Very severe **

Reference:

  1. National Institute for Health and Clinical Excellence (NICE) 2018. Chronic obstructive pulmonary disease: Management of chronic obstructive pulmonary disease in adults in primary and secondary care.

Create an account to add page annotations

Create a free account

Annotations allow you to add information to this page that would be handy to have on hand during a consultation. E.g. a website or number. This information will always show when you visit this page.

The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

Connect

Copyright 2024 Oxbridge Solutions Limited, a subsidiary of OmniaMed Communications Limited. All rights reserved. Any distribution or duplication of the information contained herein is strictly prohibited. Oxbridge Solutions receives funding from advertising but maintains editorial independence.