Monitoring

  • Follow up patients at 1 month and 3 months (according to local service provision).[1] 

    • At 1 month:[1]

      • Review discharge therapy and the patient’s understanding of the treatment regimen

      • Review the need for any long-term oxygen therapy by assessing oxygen saturation and arterial blood gas

      • Consider any new need for antibiotics or corticosteroids

      • Reassess inhaler technique

      • Evaluate the patient’s ability to cope in their usual environment

      • Document their physical capabilities

      • Document current symptoms

      • Assess and manage comorbidities.

    • At 3 months ensure the patient has returned to a stable clinical state:[1]

      • Review symptoms

      • Review the patient’s understanding of the treatment regimen

      • Reassess inhaler technique

      • Document their physical capabilities

      • Check lung function by spirometry

      • Check oxygen saturations and blood gas to assess the need for ongoing long-term oxygen therapy

      • Assess prognosis using a scoring system, such as the Body mass index, airflow Obstruction, Dyspnoea, and Exercise (BODE) index[ BODE Index for COPD Survival Prediction ]

      • Assess and manage comorbidities

      • Request a CT to check for the presence of bronchiectasis or emphysema in patients with recurrent exacerbations.

  • Advise the patient to continue with other measures that will contribute to the prevention of further exacerbations, such as seasonal vaccines, smoking cessation, and a pulmonary rehabilitation programme.

  • Some presentations of an exacerbation actually represent ongoing deterioration and disease progression.

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