Understanding and Managing COPD: Tips from a Primary Care Provider

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primary care patient using an inhaler during chronic obstructive pulmonary disease diagnosis and management
September 25, 2023

Chronic Obstructive Pulmonary Disease, or COPD, is a widespread and detrimental lung disease that affects more than 15 million adults in the United States, alone [1]. COPD is a chronic condition that causes constant limitation to one’s airflow, making it increasingly difficult for them to breathe without strain and pain over time. As COPD is a leading cause of morbidity and mortality, and the chance of developing it tends to increase with age [2], it is endlessly essential to understand and manage chronic obstructive pulmonary disease diagnosis and management, especially for seniors.

What is COPD?

COPD is an umbrella term for two main conditions: 

  • Chronic Bronchitis can be described as the inflammation and narrowing of one’s airways, which causes the production of excess mucus and a chronic cough. This critical inflammation can cause the airways to become so swollen, tight, and clogged that it becomes very challenging for air to move in and out of the lungs with ease. 
  • Emphysema occurs when there is destruction of the alveoli, or air sacs, in the lungs. The air sacs are responsible for taking in oxygen and putting out carbon dioxide each time one takes a breath. When one has emphysema, the air sacs lose their elasticity and become damaged, which results in a reduced surface area for the input of oxygen and the output of carbon dioxide. This often leads to one struggling to intake enough oxygen and put out carbon dioxide when breathing.

Common Symptoms of COPD

The most common symptoms of COPD include: 

  • Shortness of breath
  • Chronic cough
  • Wheezing
  • Excessive production of sputum

Symptoms typically worsen over time and can become debilitating to one’s life and responsibilities. 

Causes and Risk Factors of COPD

A main cause of COPD is long-term exposure to irritating gases, such as cigarette smoke. In fact, smoking causes 85-90% of all COPD cases [3] because of the harmful chemicals and irritants in tobacco smoke. These chemicals trigger chronic inflammation in the airways and lead to damage and narrowing of the air passages. People who have smoked for longer and heavier have an increased risk of developing COPD. 

Although smoking greatly increases one’s chance of developing COPD, non-smokers are not fully safe from this disease, due to environmental factors. People who have prolonged exposure to air pollution, both indoors and outdoors, have an increased risk of developing this condition. Dust, chemicals, and fumes from industrial emissions can irritate and damage the airways over time [4]. 

Finally, people with particularly dangerous work environments may be exposed to certain damaging substances that can also lead to COPD. Individuals who work in mining, construction, manufacturing, and agriculture should be aware of how much they come in contact with harmful particles and fumes, as they can damage the lungs. These hazards include silica dust, coal dust, asbestos fibers, and chemical vapors [5]. Avoidance of these hazards and using proper protection, like masks, are crucial for minimizing the risk of contracting this disease.

Is COPD Genetic?

Unfortunately, genetic factors can also play a role in the development of COPD. For example, alpha-1 antitrypsin deficiency, a genetic condition, can increase one’s chance of developing COPD, especially if genetic predisposition is combined with environmental exposures [6]. A history of respiratory tract infections during childhood can lead to lung damage over time, which can contribute to COPD. 

Chronic Obstructive Pulmonary Disease Diagnosis and Management

It is crucial to detect and diagnose COPD as early as possible for effective management and improved outcomes. If you are experiencing any of the symptoms previously mentioned, consult your doctor immediately to get the medical attention you need.

The diagnosis of COPD[7] often involves a combination of clinical assessment, medical history review, and multiple tests during primary care for seniors. Your healthcare provider will begin with a detailed evaluation of your symptoms, medical history, and exposure to risk factors. Then, they will evaluate your lung function through a physical examination and by using a stethoscope to listen for abnormal breath patterns. 

Several diagnostic tests may be performed to confirm a COPD diagnosis and determine the severity of the condition, such as: 

  • Spirometry: This is typically the primary test used to diagnose COPD, and measures lung function by evaluating how much air you can inhale with how much force, and how quickly you can empty your lungs. During this test, you will take a deep breath and blow forcefully through a tube. 
  • Imaging Studies: Chest X-rays and computed tomography 9CT) scans may be performed to evaluate the structure and condition of the lungs. These tests can detect signs of lung damage, such as emphysema, and rule out other causes of respiratory issues. 
  • Arterial Blood Gas Test: This test measures the oxygen and carbon dioxide levels in your blood. This helps report how well your lungs function in oxygenating the blood and removing carbon dioxide. 

Proper diagnosis and evaluation of COPD are essential for confirming COPD, as well as ruling out all other potential causes of symptoms, like asthma, bronchiectasis, or heart failure. 

How to Manage COPD

While COPD is a chronic disease, effective management skills can drastically improve symptoms and slow down the progression of the disease. COPD management usually involves a combination of medications, pulmonary rehabilitation, lifestyle alterations, and routine monitoring. 

  • Medications[8]: Properly medicating COPD plays a huge role in managing its symptoms and reducing flare-ups. Your doctor may prescribe bronchodilators to relax the muscles around the airways, which help you breathe with more ease. In some cases, corticosteroids may be prescribed to reduce inflammation in the airways. Keep your doctor updated on any symptoms or side effects you may experience on medications, and take the medication only as directed by your healthcare provider. 
  • Pulmonary Rehabilitation[9]: These rehabilitation programs aim to improve the overall well-being of people with COPD. They usually include exercise training, education, and support for these individuals. Exercise training helps to improve cardiovascular fitness, which strengthens respiratory muscles and enhances tolerance to physical activity. Education sessions teach how to manage symptoms, properly take an inhaler, and conserve energy/deal with breathlessness. 
  • Lifestyle Alterations: Certain lifestyle changes can have a positive impact on COPD management. The most important lifestyle choice you can make when diagnosed with COPD is to stop smoking if you haven’t already. Smoking cessation programs, nicotine replacement therapy, and support groups can help when quitting smoking. Additionally, exercising regularly, as recommended by your doctor, can improve your cardiovascular health and decrease symptoms. Finally, eating a healthy diet rich in fruits, vegetables, and whole grains provides the necessary nutrients needed to support your overall health. 
  • Exacerbation Management: Exacerbations, or “flare-ups,” are episodes of worsening symptoms that may require additional treatment and medical attention. You must develop an action plan with your doctor to manage flare-ups effectively, which may include adjusting medicine doses or increasing the use of rescue inhalers. 
  • Routine Monitoring: Regular check-ups with your doctor are essential to monitor the progression of your COPD and adjust any aspects of your management plan. During your routine visits, your doctor will assess your lung function and discuss your symptoms. Be sure to address any concerns you may have about COPD with your doctor. 

Chronic Care Management at Greater Good Health

Understanding chronic obstructive pulmonary disease diagnosis and management is crucial for people living with this lung condition. By becoming aware of the symptoms, risks, warning signs, and treatment options, you can take steps to prevent and/or treat COPD with the help of your doctor. Greater Good Health is proud to provide chronic care management in primary care for seniors. Find a primary care location near you, and contact us today to schedule your appointment.