COPD should be suspected if a person has typical symptoms, and the diagnosis confirmed by spirometry. In low- and middle-income countries, spirometry is often not available and so the diagnosis may be missed.  

There are several actions that people with COPD can take to improve their overall health and help control their COPD: 

• Stop smoking: people with COPD should be offered support to quit smoking
• Do regular exercise
• Get vaccinated against pneumonia, influenza and coronavirus.

Inhaled medication can be used to improve symptoms and reduce flare-ups. There are different types of inhaled medication, which work in different ways and can be given in combination inhalers, if available. 

 Some inhalers open the airways and may be given regularly to prevent or reduce symptoms, and to relieve symptoms during acute flare-ups. Inhaled corticosteroids are sometimes given in combination with these to reduce inflammation in the lungs.   

Inhalers must be taken using the correct technique, and in some cases with a spacer device to help deliver the medication into the airways more effectively. Access to inhalers is limited in many low- and middle-income countries. In 2021, salbutamol inhalers were generally available in public primary healthcare facilities in half of low- and low-middle income countries.  

Flare-ups are often caused by a respiratory infection, and people may be given an antibiotic or steroid tablets in addition to inhaled or nebulised treatment as needed. People living with COPD must be given information about their condition, treatment and self-care to help them to stay as active and healthy as possible. 

WHO RESPONSE 

COPD is included in the WHO Global Action Plan for the Prevention and Control of Noncommunicable Diseases (NCDs) and the United Nations 2030 Agenda for Sustainable Development.  

WHO is taking action to extend diagnosis of and treatment for COPD in several ways. 

 The WHO Package of Essential Noncommunicable Disease Interventions (PEN) (https://www.who.int/publications/i/item/who-package-of-essential-noncommunicable-(pen)-disease-interventions-for-primary-health-care) was developed to help improve NCD management in primary health care in low-resource settings. PEN includes protocols for the assessment, diagnosis and management of chronic respiratory diseases (asthma and chronic obstructive pulmonary disease), and modules on healthy lifestyle counselling, including tobacco cessation and self-care.   

Rehabilitation 2030 is a new strategic approach to prioritise and strengthen rehabilitation services in health systems. Pulmonary rehabilitation for COPD is included in the Package of Interventions for Rehabilitation, currently under development as part of this WHO initiative.   

Reducing tobacco smoke exposure is important for both primary prevention of COPD and disease management.   

The Global Alliance against Chronic Respiratory Diseases (GARD) (https://www.who.int/groups/global-alliance-against-chronic-respiratory-diseases-(gard)) contributes to WHO’s work to prevent and control chronic respiratory diseases. GARD is a voluntary alliance of national and international organisations and agencies from many countries committed to the vision of a world where all people breathe freely.    

Source: World Health Organization