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Chronic obstructive pulmonary disease - Management
How do I know my patient has it?
- There is no single diagnostic test for chronic obstructive pulmonary disease (COPD).
- Make a diagnosis of COPD if the person meets all of the following criteria:
- Age older than 35 years.
- Presence of a risk factor (for example smoking, history of smoking, or an occupational exposure).
- Typical symptoms.
- Absence of clinical features of asthma.
- Presence of airflow obstruction confirmed by post-bronchodilator spirometry.
- Individual physical signs are not diagnostic of COPD, and in some people there may be no abnormal physical signs.
- Consider alternative diagnoses.
- Consider the possibility of alpha1-antitrypsin deficiency if the person is younger than 40 years of age or has a family history of alpha1-antitrypsin deficiency.
- If suspected, refer the person to a respiratory specialist for investigations and treatment.
- Reconsider the diagnosis of COPD (and consider the possibility of asthma) if the person has a marked response to drug treatment, illustrated by either:
- A marked improvement in symptoms, or
- Return of forced expiratory volume in 1 second (FEV1) and FEV1/FVC (forced vital capacity) ratio to normal.
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