Module A
Algorithm Module B >>
Patient with suspected or confirmed COPD presents to primary care [ A ] Susspect COPD
Perform brief clinical assessment to determine if patient is stable
Is patient in acute exacerbation? Management of Acute Exacerbation Use Module B
Complete clinical assessment Medical history: including smoking status, activity level, exercise tolerance Physical exam: including assessment of airflow obstruction, spirometry and oximetry if FEV1 50% or less. Assess severity of the disease - Prevention and risk reduction (including smoking cessation, vaccination and patient education) [ D ]
- Pharmacotherapy including bronchodilators, inhaled glucocorticoids [ E ]
-Supplemental oxygen or lobg-term oxygen therapy [F]
Further Investigation to Exclude Other Diagnoses [C]
Pulmonary rehabilitation (including exercise training, education, psychological and nutritional counseling) [G]
Other interventions [H]
Initiate/adjust COPD therapy (see sidebar B) Evaluate and provide appropriate treatment
Are there any associated conditions present? - Cardiovascular disease - Depression, anxiety - Nutrition - Sleep disorders
Evaluate and provide appropriate treatment: - Cardiovascular disease [ I ]
Evaluate and provide appropriate treatment: - Depression or anxiety [ J ]
Evaluate and provide appropriate treatment:- Nutrition [ K ]
Evaluate and provide appropriate treatment:- Sleep disorders [ L ]
Patient in need of surgery [ M ]
Patient plans to travel at high altitude [ N ]
Initiate/adjust COPD therapy (see sidebar B)
Advise patient to maintain weight and prevent weight gain [ E ]