When to choose mono, dual or triple therapy in chronic obstructive pulmonary disease (COPD)
Published: 22nd October 2024
Overview
- It is essential to confirm COPD diagnosis with spirometry before starting any treatment.1
- Single long-acting bronchodilators should be used in the first instance for patients with no history of asthma, with a long-acting agent added if the patient's symptoms have not improved. For patients with asthma history, inhaled corticosteroid with a bronchodilator should be started first.2
- The MMRC dyspnea score followed by the CAT score should be used to assess control in patients with COPD.2
- Doctors need to master the correct use of inhalers to effectively demonstrate devices and evaluate patient technique.2
- The COPD-X guidelines contain stepwise approaches for up titration from mono bronchodilator therapy to dual or triple therapy.2
- Careful consideration is needed when contemplating reducing or stopping inhaled corticosteroids.3
COPD is a chronic respiratory condition characterised by persistent airflow limitation, often requiring long-term management.4 Despite its prevalence, many patients are misdiagnosed or receive an incorrect or inappropriate prescription, underscoring the need for proper diagnostic measures.2
