chronic%20obstructive%20pulmonary%20disease
CHRONIC OBSTRUCTIVE PULMONARY DISEASE
Treatment Guideline Chart

Chronic obstructive pulmonary disease (COPD) is an inflammatory respiratory disease characterized by reversible airflow limitation.

The patient usually has chronic cough, sputum production or dyspnea with or without history of risk factors for the disease.

The chronic airflow limitation is caused by a combination of small airways disease and parenchymal destruction.

It is a preventable and treatable disease.

Chronic%20obstructive%20pulmonary%20disease Management

Monitoring

Prior to discharge from the hospital, check the patient based on the following criteria:

  • Able to use long-acting either beta2-agonists and/or anticholinergics with or without inhaled corticosteroids
  • Inhaled beta2-agonist is needed every 4 hours or less frequently
  • Able to walk across the room (if previously ambulatory)
  • Able to eat and sleep without frequent interruptions due to breathing difficulty
  • Clinically stable for 12-24 hours
  • ABG stable for 12-24 hours
  • Patient and caregiver adequately understand correct medication use
  • Home care arrangements (eg O2 delivery) are in place
  • Patient, family and physician are confident that patient can manage well

Follow Up

  • A follow-up assessment must be carried out within 4-12 weeks following discharge from hospital for exacerbations
  • Check patient’s ability to cope in his environment
  • Measure FEV1
  • Check inhaler technique
  • Check understanding and ability to follow treatment regimen
  • Assess need for long-term O2 therapy and/or home nebulizer for patients with very severe COPD
  • Check status of comorbidities
  • Remote consultations/follow-up may be considered during COVID-19 pandemic with the following conditions:
    • Patient is able to understand the process and can provide clear information
    • Regular COPD follow-up
    • Medical records and laboratory tests are accessible to the healthcare provider
    • Access to medication is possible
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