A consensus-based article that sets out a simple treatment pathway based on the predominant characteristics
PCRS advocate a pragmatic approach to the pharmacological management of patients with COPD guided by the predominance of breathlessness and/or exacerbations and the presence or absence of comorbid asthma. Clinicians must undertake a holistic evaluation for alternative causes of persistent daily symptoms or repeated exacerbations and consider seeking advice from a respiratory specialist before escalating to triple therapy (a respiratory specialist may be a GP/nurse/consultant).
The one-minute sit to stand test (1-MSTST) has become the test of choice during the pandemic for measuring exercise capacity, both at in-person and virtual appointments due to the inability to conduct robust six minute or incremental / endurance shuttle walk tests (6MWT/ ISWT/ ESWT). It can easily be conducted in the patient’s home or a small clinic room, requires little equipment, is quick to undertake and yields useful information about the patient’s physiological response to exercise.
In this article we review the major changes in the 2023 GOLD report as they impact on the initial and ongoing pharmacological management of COPD and consider the implications for primary care in the UK. Dr Fiona Mosgrove is a GP in Aberdeen and Clinical Lead for the Grampian Respiratory Improvement Programme. Dr Tracey Lonergan is the Policy Coordinator for the Primary Care Respiratory Society and Medical Writer with a special interest in respiratory disease.
The high rate of empirical antibiotic use for the treatment of suspected respiratory tract infections (RTIs) and COPD exacerbations remains a cause for concern in the face of increasing antibiotic resistance.
Primary care practitioners should seek to identify and provide proactive support to older people living with frailty in the community.