COPD guidelines have changed—and if you’re managing COPD in primary care, there are a few updates worth knowing.
In this episode, I walk through how to approach a patient with COPD at a routine visit, especially when you’re seeing them for the first time or inheriting their care from another provider.
We’ll cover how to confirm the diagnosis with spirometry, how to think about GOLD 1–4 alongside the ABE assessment, and how the mMRC and CAT scores fit into your assessment. We’ll also talk about alpha-1 antitrypsin deficiency testing, blood eosinophils and inhaled corticosteroids, initial inhaler therapy, and what to monitor at follow-up.
I also walk through the pieces of COPD management beyond medications—including smoking cessation, vaccinations, exercise and nutrition, pulmonary rehabilitation, and management of comorbidities.
In this episode:
00:00 – Introduction + COPD guideline updates
01:03 – Approaching COPD management in primary care
01:53 – Confirming COPD with spirometry and FEV1/FVC
03:01 – Pre-COPD and PRISm
03:53 – GOLD 1–4 and the ABE assessment
05:12 – Using the mMRC and CAT scores
06:23 – What to assess at a COPD follow-up visit
07:50 – Alpha-1 antitrypsin deficiency testing
08:26 – Blood eosinophils and inhaled corticosteroids
09:37 – COPD management beyond inhalers
11:15 – Pulmonary rehabilitation and comorbidities
11:37 – SABA, SAMA, LABA, LAMA, and ICS
12:21 – Initial COPD treatment by GOLD ABE group
13:50 – Initial treatment for Groups A and B
14:35 – COPD follow-up and spirometry
15:04 – Chest imaging and lung cancer screening
15:46 – When to refer to pulmonology
COPD cheat sheet + Digital NP Binder: realworldnp.com/binder
For a full transcript and conversation chapters, visit the blog: https://www.realworldnp.com/blog/copd-management
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