Guidelines for COPD Treatment

The Global Initiative for Chronic Obstructive Lung Disease (GOLD) is an international program aimed at helping people with chronic obstructive pulmonary disease (COPD).

COPD refers to a number of lung diseases that interfere with normal breathing; the effects of these diseases cannot be reversed, according to the American Lung Association (ALA). The two most common forms of COPD are emphysema and chronic bronchitis; often these two diseases occur at the same time.

In chronic bronchitis, the bronchial tubes are inflamed and eventually become scarred. In emphysema, the walls in the air sacs in the lungs no longer are able to stretch, instead becoming weakened and able to break.

Smoking is the main risk factor for COPD. Other risk factors include exposure to air pollution, secondhand smoke, childhood respiratory infections and family history.

As someone with COPD, you may find it helpful to know about the four components of care described in the GOLD guidelines. GOLD suggests certain treatments and actions under each component. Understanding this guide can help you take an active role in managing COPD.

Component 1: Assess and monitor

Your health care team will want to learn about your risk factors for COPD (such as smoking), as well as how intensely and for how long you were exposed to them. Your provider will ask some questions about your health and family history: 

• Do you have asthma, allergies or sinusitis? 

• Have you had any lung problems or other illness? 

• Have you ever had to go to the hospital for a lung problem? 

• Does anyone in your family have COPD? 

• What are your symptoms?

• Does your COPD make you miss work, cause family problems, or make you feel anxious or depressed?

Your provider may order certain tests to further assess your condition.

Component 2: Reduce risk factors

Quitting smoking is the main focus of this component of care. If you smoke, your health care team will urge you to quit and work with you to do so. Your provider may offer you quitting aids such as nicotine replacement. Other important risk factors to reduce include exposure to secondhand smoke, workplace hazards and air pollution.

Component 3: Manage stable COPD

Your team will create a treatment plan for you and update it, depending on how you are feeling. Many people with COPD have pulmonary rehabilitation to help improve their quality of life. You will likely need to take medicines and get an annual flu shot. Some people also need oxygen therapy.

You should follow your health care team's instructions and take medicines exactly as directed. Studies show that the longer and more committed a person is to a pulmonary rehabilitation program, the better the results.

Component 4: If symptoms worsen

When your symptoms of COPD become worse, your provider will assess the severity of the problem by using lung function tests and other assessments. Depending on the results, your provider may make medication changes. You may need to stay in the hospital if your COPD can't be treated well at home.