For Health Professionals

Why COPD Matters

Chronic obstructive pulmonary disease (COPD) is a common, progressive lung disease that remains underdiagnosed and undertreated. Early identification, accurate diagnosis, and evidence-based management can improve symptoms, reduce exacerbations, preserve lung function, and improve quality of life.

COPD is:

A leading cause of illness and death in the United States
A major contributor to avoidable healthcare utilization and costs
A largely preventable disease
A condition where early intervention can significantly improve outcomes

COPD in New Hampshire

COPD affects thousands of individuals across New Hampshire, with many people living with the disease without a diagnosis.

In New Hampshire:

Approximately 130,000 adults are estimated to have COPD, with many remaining undiagnosed.
COPD prevalence varies significantly across the state, with higher rates in some rural communities.
COPD prevalence increases with age and is higher among populations experiencing socioeconomic barriers, including lower income and education levels.
Pulmonary rehabilitation remains underutilized despite evidence showing significant benefits for people living with COPD.

"As with any chronic disease, early and correct diagnosis is important for several reasons. It is especially important to distinguish those folks with asthma, versus COPD, versus the 10-20% with overlap of both diseases. Treatment for these diseases uses many of the same medications, but order of use is very different and can lead to major complications if used inappropriately."

— Albee Budnitz, MD, FACP, FCCP

Recognizing Patients at Risk

COPD should be considered in patients with persistent respiratory symptoms, particularly those with a history of exposure to lung irritants.

Common Risk Factors Include:

Tobacco Exposure

Current or former cigarette smoking
Pipe, cigar, or other tobacco use
Secondhand smoke exposure

Occupational and Environmental Exposures

Workplace dust
Chemical fumes
Vapors
Industrial exposures
Air pollution
Wood smoke and other biomass exposures

Genetic Risk Factors

Alpha-1 antitrypsin deficiency (Alpha-1) is a rare inherited condition that can increase the risk of developing COPD.

Healthcare providers should consider Alpha-1 testing for appropriate patients, including those with:

COPD at a younger age
COPD without significant smoking history
Family history of COPD or unexplained lung disease

Recognizing COPD Symptoms

Symptoms of COPD often develop slowly and may be overlooked or mistaken for normal aging.

Common symptoms include:

Chronic cough
Chronic mucus (phlegm/sputum) production
Shortness of breath during daily activities
Wheezing
Chest tightness
Reduced exercise tolerance
Frequent respiratory infections

Patients may gradually limit activities to avoid breathlessness, making it important to ask about changes in daily function.

Diagnosis of COPD

The Role of Spirometry

Spirometry is essential for confirming COPD diagnosis and assessing airflow limitation.

Healthcare professionals should consider spirometry for patients with:

Persistent cough
Shortness of breath
History of tobacco exposure
Occupational exposure to lung irritants
Recurrent respiratory infections
Unexplained respiratory symptoms

COPD severity classification is based on post-bronchodilator spirometry results.

COPD and Asthma: The Importance of Differentiation

COPD and asthma share some symptoms and treatments, but they are different conditions requiring individualized management.

Some patients may have features of both conditions, known as asthma-COPD overlap.

Accurate diagnosis helps ensure patients receive appropriate treatment and avoid unnecessary complications.

Managing COPD

While COPD cannot currently be cured, treatment can reduce symptoms, improve daily function, slow disease progression, and prevent complications.

The goals of COPD management include:

Relieving symptoms
Improving exercise tolerance and activity levels
Preventing and treating exacerbations
Reducing exposure to lung irritants
Improving overall health and quality of life

Treatment Approaches

Smoking Cessation

Smoking cessation is the most important intervention for patients who smoke.

Healthcare professionals can support cessation through:

Counseling
Medication options
Referrals to cessation programs

Medications

Treatment may include:

Bronchodilators
Combination inhalers
Other medications based on symptoms and exacerbation history

Assessing inhaler technique and medication adherence should be part of routine care.

Pulmonary Rehabilitation

Pulmonary rehabilitation is a comprehensive program that includes:

Exercise training
Breathing techniques
Education
Self-management strategies

Benefits include:

Improved exercise capacity
Reduced breathlessness
Improved quality of life
Increased confidence managing COPD

Physical Activity

Encouraging appropriate physical activity helps patients maintain strength, endurance, and independence.

Oxygen Therapy

Long-term oxygen therapy may benefit appropriate patients with chronic low oxygen levels.

COPD Exacerbations (Flare-Ups)

COPD exacerbations are episodes when symptoms worsen beyond normal day-to-day variation.

Common triggers include:

Respiratory infections
Poor air quality
Smoke exposure
Weather changes
Other illnesses

Healthcare professionals can help patients:

Recognize early warning signs
Develop an action plan
Understand when to seek medical attention
Reduce future exacerbation risk

COPD and Other Health Conditions

COPD frequently occurs alongside other chronic conditions that can affect treatment decisions and quality of life.

Common comorbidities include:

Heart disease
Diabetes
Asthma
Anxiety and depression
Sleep disorders
Osteoporosis

Comprehensive COPD care includes identifying and managing these related conditions.