COPD Exacerbation Top 10

  1. What can prevent exacerbations of COPD?
  2. What is the best way to tell the start of an exacerbation from day-to day variation in symptoms?
  3. What is the best way to tell the difference between an exacerbation and a different cause of changing symptoms in a person with COPD?
  4. What is the optimal combination of treatments at COPD exacerbations and what is the best way to decide this for individual patients?
  5. What are the associations between co-morbidity (other medical conditions) and risk of COPD exacerbations?
  6. Which palliative care regimes should be used to treat an exacerbation, in which circumstances, and what are the potential benefits? (‘Palliative care’ is defined by the World Health Organisation as an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering).
  7. Why do some exacerbations recur (happen again) following treatment?
  8. What are the risks and benefits of 'rescue packs' used to prevent COPD exacerbations, and how should they be best used?
  9. How does the presence of anxiety and depression affect the prevention, diagnosis, and treatment of COPD exacerbations?
  10. What are the risks and benefits of long-term antibiotics to prevent COPD exacerbations, and how should they be best used?

The following questions were also discussed and put in order of priority at the workshop:

  1. What is the best way to treat breathlessness during a COPD exacerbation?
  2. When should a COPD exacerbation be treated with steroids alone, antibiotics alone or both?
  3. What is the value of integrated respiratory teams (health-care professionals working across organisations, and/or professions) in preventing COPD exacerbations and COPD admissions?
  4. What is the role of nutrition in the prevention and treatment of exacerbations?
  5. What factors determine whether someone with a COPD exacerbation can be managed at home or needs admission to hospital?
  6. Does regular exercise reduce the risk of having an exacerbation (and to what level of exercise)?

    Document downloads

    For full details of all of the questions identified by this PSP, please see the document below.