NICE issues revised COPD guidance

NICE has issued updated COPD guidance designed to improve COPD diagnosis and treatment of the disease.

NICE guidance intends to improve care and outcomes for those with COPD (Photograph: SPL)
NICE guidance intends to improve care and outcomes for those with COPD (Photograph: SPL)

The institute said the diagnosis and management of adults with COPD in primary and secondary care can, and should, be better.

The new guidance advises measuring post-bronchodilator spirometry to confirm the diagnosis of COPD. In addition, pulmonary rehabilitation should be made available to all appropriate patients with COPD, including those who have had a recent hospitalisation for an acute exacerbation, it says.

When appropriate, GPs should offer nicotine replacement therapy, varenicline or bupropion to patients who plan to stop smoking, combined with an appropriate support programme to optimise smoking quit rates for people with COPD.

GPs should also note the potential risk of developing side-effects, including non-fatal pneumonia, in people with COPD treated with inhaled corticosteroids, and they should be prepared to discuss this with patients, NICE says.

Dr Fergus Macbeth, director of the centre for clinical practice at NICE, said: ‘This new guideline... will help complement a wider DoH national strategy for COPD to identify the best ways to improve care and outcomes for those with COPD, and to reduce the overall prevalence of the disease.’

Dr Michael Rudolf, consultant respiratory physician at Ealing Hospital and Chair of the Guideline Development Group, said the guidance would help to diagnose many people suffering from the disease who had not yet been identified.

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