COPD - a primary health care checklist

People with COPD who have an inhaler should have regular checks to make sure they are using it correctly in order to get the right dose of medicine into their lungs.

The frequency of checks will vary between patients. In general, checks should be done:
a) at the start of treatment
b) every year as part of an annual review of treatment
c) if the treatment changes
d) after a sudden flare up or exacerbation

Experts recommend that doctors and nurses should work with people with COPD (and their family members or carers as appropriate) to create an individualised self-management plan.

This action plan should clarify exactly what to do if the person suffers an exacerbation of their COPD.

If you are unsure whether your parent has such a plan, then take a look at this example of a COPD self management plan which has been developed by Asthma + Lung UK.

Some people with COPD can benefit from keeping a supply of medicines at home which they can use if they get an exacerbation. These medicines are usually a short course of oral corticosteroids and a short course of oral antibiotics.

Your healthcare team will know whether you will benefit from these or other medicines. If so, instructions regarding when and how to use these medicines should be included in a COPD action plan (see above)

It is essential to let the heath care team know when these medicines have been used and to check whether they need replacing.

People with COPD can find it difficult to get about because of breathlessness. They often need to walk more slowly or stop more frequently to avoid becoming too breathless. This shortness of breath can also affect other essential activities such as bathing or dressing.

Everyday life with COPD can be challenging and people with COPD may also suffer from anxiety or depression.

Pulmonary rehabilitation programmes can help people live better with COPD. They can improve a person’s exercise capacity, quality of life, symptoms and levels of anxiety and depression. These programmes include a range of support tailored to the person’s needs and typically include exercises, information about COPD, and diet advice.

Your healthcare team will know whether you are likely to benefit from this kind of programme and, if so, they can arrange a referral.

Home oxygen treatment is only suitable for people with stable COPD who have persistently low levels of oxygen in the blood. It will be up to your COPD care team to decide if you are eligible for home oxygen. If the team consider it might be useful, then they will arrange further tests to help them decide.

One of these tests is a blood test to check how much oxygen is actually circulating in the body (arterial blood gases) and can indicate whether long term oxygen could improve things.

Oxygen is supplied through a tube (placed just inside the nose) or a mask. It is usually given for at least 15 hours during the day or night.

All people with COPD should be offered:
a) Annual flu vaccine (new injection every year usually autumn)
b) Pneumococcal vaccine (once only injection at any time of year)
c) COVID vaccine at intervals determined by evolving national policies

Pneumococcal vaccine reduces the risk of community-acquired pneumonia and reduces the risks of exacerbations in people with moderate to severe COPD.