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Understanding Your COPD Treatment Plan

Understanding Your COPD Treatment Plan

Your doctor will work with you to develop a comprehensive plan that includes a mix of medication, therapy and lifestyle changes.

Chronic obstructive pulmonary disease (COPD), is a term that describes a few types of progressive lung disease—most notably emphysema and chronic bronchitis—that worsen over time. Most people with the condition experience symptoms that include:

  • Chronic cough, which may be intermittent or unproductive
  • Shortness of breath (dyspnea) that is persistent, progressive and typically worsens with exercise
  • Chronic production of sputum

Every patient’s experience with COPD is different. Some lifestyle habits (like smoking) can lead to a more rapid progression of the condition, while others (like high intensity exercise) can help slow the decline of lung function. There’s no cure for COPD, but there are steps you can take to treat and manage the condition and improve your quality of life.

COPD medications
Once you’re diagnosed with COPD, your healthcare provider (HCP) will work with you to decide which treatment options may be best to help manage your symptoms. These may include the following:

Bronchodilators help relax the muscles around your airways to make breathing easier. Most are administered with an inhaler or a nebulizer so that you breathe the medication directly into your lungs. Depending on the severity of your COPD, your HCP may prescribe:

  • Short-acting bronchodilators. These are taken when you need quick relief from COPD symptoms. The effects of these medications wear off within a few hours.
  • Long-acting bronchodilators. These work more slowly, but provide relief lasting for 12 to 24 hours.

There are two specific types of bronchodilators, and either one can be a short-acting medication or a long-acting medication. These include:

  • Beta agonists, which relax tightened muscles around your airways to make breathing easier
  • Anticholinergics, which prevent airway muscles from contracting while helping to clear mucus from the lungs

Combination medications contain a mix of two or three COPD medications: a beta agonist, an anticholinergic and a corticosteroid medication. In general, using inhaled steroids alone is not a preferred treatment. If your COPD is more severe, or if your symptoms flare up often, your HCP may prescribe a combination of medicines that includes a bronchodilator and an inhaled steroid.

Be sure to work closely with your HCP on how to administer your medication, as various inhalers and nebulizers may work differently. If you have any questions about how to properly take your medication, ask. Improper use of treatment devices may result in not getting the right amount of medication.

Additional COPD treatments
Medication alone often isn’t enough to properly manage COPD. Your HCP may recommend one or more of these additional therapies:

Pulmonary rehabilitation is an outpatient group program you can join to learn more about how to manage your COPD. Led by various medical professionals, pulmonary rehab can help you gain the skills you need to increase fitness levels, improve lung function and perform daily activities. It also gives you the opportunity to meet and connect with others who are managing COPD.

Supplemental oxygen may be recommended for patients with severe cases of COPD who have chronically low levels of oxygen in the blood as a result of the disease. In certain patients, it can help improve quality of life.

Surgery is often used as a last resort, but it’s an option for some people who have severe COPD that isn’t improving with the use of medications and other therapies. Surgical interventions include:

  • Bullectomy, which removes bullae, large air spaces that result when the lungs’ air sacs are destroyed (these can interfere with your breathing if left untreated)
  • Lung volume reduction, which removes damaged tissue from the lungs to improve lung function and quality of life
  • Lung transplant, in which the damaged lung is replaced with a healthy donor lung

Lifestyle changes for COPD management
In addition to your treatment plan, your HCP will also likely recommend you make certain lifestyle changes, such as the following:

Quit smoking. If you smoke, quitting—and staying quit—is the most important step you can take to slow the progress of the disease and improve symptoms. If you have trouble quitting, talk to your HCP about using smoking cessation aids.

Stay active. COPD can make it difficult to breathe, which can make exercise a challenge. But staying active when you have COPD can actually strengthen the muscles that help you breathe, which in turn can help improve symptoms. Your HCP can recommend COPD-friendly activities to try, such as walking, biking or swimming.

Pay attention to your diet. This is especially important if you have trouble eating due to shortness of breath or fatigue related to COPD. If dietary supplementation would make sense in your case, your HCP can provide strategies for getting the calories and the nutrients your body needs to stay healthy. Strategies may include eating smaller meals more frequently, resting before you eat and taking nutritional supplements. 

Prevent illness. Taking steps to avoid lung infections is an important part of COPD management. Your HCP will likely recommend getting an annual flu shot as well as getting vaccinated for pneumonia. It also helps to wash your hands regularly and avoid interactions with others who are sick. Your HCP may even preemptively prescribe antibiotics or antiviral medications to keep on hand in case you come down with an infection or get the flu.

Pay attention to air quality. Take steps to reduce allergens in your home such as dust mites and pet dander, which can trigger COPD symptoms. Avoid secondhand smoke and other irritating fumes, whether at home or elsewhere. You can check the air quality index for outdoor pollution before leaving your home and adjust your plans to avoid spending prolonged periods outside on poor air quality days.

Consider complementary therapy. Some people benefit from adding therapies such as massage, acupuncture or meditation to their COPD management plan. These approaches may help ease pain and side effects, reduce the anxiety that often comes with the disease and improve overall quality of life. Before you try any type of complementary therapy, consult with your HCP. 

Putting it all together
Everyone’s COPD is different, so be sure to work with your HCP to discuss what to include in your well-rounded management plan. Once you have your strategy in place, following it is essential. By incorporating a mix of medications, therapies and lifestyle changes, you can help:

  • Manage COPD symptoms
  • Slow the progression of COPD
  • Boost overall health and lung health by staying active
  • Prevent or treat COPD-related health complications

If your symptoms become increasingly worse despite following your plan, check with your HCP, as this may be a sign that you’d benefit from a change in treatment. Always be on the lookout for a COPD exacerbation—when your symptoms suddenly become worse, typically as a result of an infection—which will require prompt treatment and possibly hospitalization.

Medically reviewed in September 2020. Updated in December 2020.

Sources:

Polastri M, Clini EM, Nava S, Ambrosino N. "Manual Massage Therapy for Patients with COPD: A Scoping Review." Medicina (Kaunas). 2019;55(5).
Herath SC, Normansell R, Maisey S, Poole P. "Prophylactic antibiotic therapy for chronic obstructive pulmonary disease (COPD)." Cochrane Database Syst Rev. 2018;10:CD009764.
Centers for Disease Control and Prevention. "Vaccination of Adults with Lung Disease Including Asthma." Published May 2, 2016.
Ingadottir AR, Beck AM, Baldwin C, et al. "Oral nutrition supplements and between-meal snacks for nutrition therapy in patients with COPD identified as at nutritional risk: a randomised feasibility trial." BMJ Open Respir Res. 2019;6(1):e000349.
van de Bool C, Rutten EPA, van Helvoort A, Franssen FME, Wouters EFM, Schols AMWJ. "A randomized clinical trial investigating the efficacy of targeted nutrition as adjunct to exercise training in COPD." J Cachexia Sarcopenia Muscle. 2017;8(5):748-758.
Morris NR, Walsh J, Adams L, Alision J. "Exercise training in COPD: What is it about intensity?" Respirology. 2016;21(7):1185-1192.
Chestnutt AN, Chestnutt MS, Prendergast NT, Prendergast TJ. "Chronic Obstructive Pulmonary Disease." In: Papadakis MA, McPhee SJ, Rabow MW, eds. Current Medical Diagnosis and Treatment 2020. McGraw-Hill; 2020.

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