Initial Consultation for COPD

Medical History Assessment

The European Respiratory Society recommends documenting symptoms including cough, sputum production, and dyspnea (both at rest and with exertion) in patients with COPD 2
The European Respiratory Society suggests recording past medical history of asthma, allergies, and other respiratory diseases in patients with COPD 2
The European Respiratory Society recommends assessing for co-morbidities that may affect treatment approach in patients with COPD 2
The European Respiratory Society suggests evaluating any unexplained weight loss in patients with COPD 2
The European Respiratory Society recommends documenting exposure history, particularly smoking (pack-years), occupational and environmental exposures in patients with COPD 2

The European Respiratory Society recommends measuring respiratory rate, weight, height, and BMI in patients with COPD 2
The American Thoracic Society suggests assessing for signs of respiratory distress, cyanosis, and peripheral edema in patients with COPD 3
The European Respiratory Society recommends looking for signs of cor pulmonale and pulmonary hypertension in patients with COPD 1, 4

The American Thoracic Society recommends performing spirometry to confirm diagnosis of COPD, as the critical feature that characterizes COPD is the inability to reverse airflow limitation fully 4
The European Respiratory Society suggests obtaining chest radiograph to exclude other conditions such as lung cancer in patients with COPD 1, 6
The American Thoracic Society recommends considering arterial blood gas analysis if severe disease is suspected in patients with COPD 1

The American Thoracic Society recommends considering alpha-1 antitrypsin deficiency testing for patients less than 40 years old or with limited smoking history 1, 5

The European Respiratory Society recommends discussing smoking cessation as the primary intervention to reduce disease progression in patients with COPD 1, 7
The American Thoracic Society suggests evaluating need for pulmonary rehabilitation in patients with COPD 1, 8
The European Respiratory Society recommends assessing need for oxygen therapy in hypoxemic patients with COPD 1, 8
The American Thoracic Society suggests reviewing inhaler technique if patient is already using inhalers 8

The European Respiratory Society recommends considering referral for suspected severe COPD to confirm diagnosis and optimize treatment 1, 4
The American Thoracic Society suggests referring for assessment for oxygen therapy to measure blood gases in patients with COPD 1, 4
The European Respiratory Society recommends considering referral for patients with COPD under 40 years to identify alpha-1 antitrypsin deficiency 4

The American Thoracic Society recommends scheduling follow-up to assess response to treatment in patients with COPD 8
The European Respiratory Society suggests planning for regular spirometry to monitor disease progression in patients with COPD 8
The American Thoracic Society recommends arranging for reassessment of inhaler technique and patient's understanding of treatment regimen in patients with COPD 8

The European Respiratory Society recommends evaluating inhaler technique in patients already on treatment to avoid inadequate assessment of inhaler use 8
The American Thoracic Society suggests assessing for comorbidities that may affect treatment approach or mimic COPD symptoms to avoid missing comorbidities 2