COPD NICE Referral Criteria

Primary Care Respiratory Society UK (PCRS-UK)

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Specialist referral

Diagnostic referral

Consider referral for assistance with the diagnosis of COPD in the circumstances:-

Where there is diagnostic uncertainty
Dysfunctional breathing
Age <40 years or alpha-1-antitrypsin deficiency

Referral in "red flag" symptoms

Refer urgently for CXR and specialist input in the presence of the following "red flag" symptoms

Haemoptysis
Fliger clubbing
unexplained rapid weight loss
Night sweats

Also consider referral for specialist management advice in the following circumstances

Onset of cor pulmonale or presence of significant co-morbidities
Suspected severe and deteriorating COPD despite maximal therapy, or rapid decline in, or symptoms disproportionate to, lung function
Patients needing oxygen assessment
patients experiencing frequent infections/exacerbations
Patients requesting second opinion

The PCRS-UK is grateful to Dr Kevin Gruffydd-Jones, Dr John Haughney, Dr Rupert Jones and Dr Noel O'Kelly as authors of the PCRS-UK booklet, Diagnosis and Management of COPD in Primary Care, on which this quick reference guide is based. This Quick Reference Guide has been supported by an educational grant from Allen & Hanburys, the specialist respiratory division of GlaxoSmithKline. The views expressed in this guide is not necessarily those of either the sponsor or the Primary Care Respiratory Society UK (PCRS-UK). © PCRS-UK

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