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Understanding the different steps of your COPD care journey can feel overwhelming. What can you expect from your healthcare provider at each stage? What treatment options might be available to you? This module breaks the patient journey into clear phases and guides you through each one.
Some aspects of COPD care apply across all stages, no matter where you are in your journey. Self-management strategies include smoking cessation—one of the most important steps you can take in managing your disease. They also involve learning about healthy lifestyle choices, staying up to date with vaccinations (including a yearly flu shot and a pneumococcal vaccine to prevent chest infections), using your treatments correctly, and avoiding exposure to lung irritants. It is also important to know how to recognize and manage a sudden worsening of your breathing symptoms, known as a flare-up or exacerbation. Some flare-ups can be managed at home, but others warrant urgent medical attention.
Shared decision-making with your healthcare team—where your voice is considered at every step of your disease management—is essential to high-quality care. Your care team will also monitor for other health conditions that often occur alongside COPD, known as comorbidities, and will refer you to a specialist if needed.
If you experience signs of a severe COPD flare-up, also called a COPD exacerbation, your patient journey skips these steps - you need emergency care right away! Find out in the graphic below which symptoms indicate a severe COPD flare-up and how to proceed. Don’t forget to follow up with your regular doctor to review your treatment plan after an emergency room visit or a hospital stay for a COPD flare-up.
The information below covers care at both the primary care level (your family doctor or general practitioner) and the specialist care level. For the best experience, we recommend reviewing the earlier modules on this Patient Portal to become familiar with key terms. You can also consult our Glossary for additional support.
Keep in mind that access to certain healthcare providers and medications can vary depending on your country and local healthcare policies. The chart below gives a general overview, but the exact steps or options may be different where you live.
If you experience symptoms such as a cough that keeps coming back (with or without phlegm), breathlessness – especially during physical activity – wheezing, or frequent chest infections, it is important to visit a doctor to find out what is going on. This is especially important if you smoke or used to smoke, are over 40, or have a history of exposure to risk factors for COPD.
You’ll likely visit your general practioner (GP) first. Your GP will assess you by asking specific questions about your symptoms and medical history, perform a physical exam, and – if available, perform a lung function test called spirometry. Your doctor might also order additional tests, such as a blood test. It is important to know that asthma must be ruled out before a COPD diagnosis is made, as the two conditions require different treatment approaches. Spirometry is the most important test for diagnosing both asthma and COPD. Your doctor may also check for heart conditions, such as heart failure, because these can cause similar symptoms and often occur alongside COPD.
After the evaluation, a clear treatment plan will be provided, and follow-up care can usually continue with your GP. One of the most important parts of COPD treatment—besides quitting smoking if this applies to you—is using one or more inhalers. The type and number of inhalers you need depend on how severe your symptoms are and how likely you are to have flare-ups. These inhalers contain medications called bronchodilators, which help open your airways and make breathing easier. If you have a high level of eosinophils in your blood (a type of white blood cell involved in inflammation), you may be prescribed an inhaler that also contains inhaled corticosteroids (ICS). ICS are not helpful for everyone with COPD, so your healthcare provider will carefully evaluate whether they are appropriate for you.
It's important to attend a regular COPD review with your GP, at least every six months. This check-up helps make sure your COPD action plan is still right for you, that you're on the best treatment and dose for your current situation, and that you're using your inhaler correctly. Get optimally prepared for your follow-up visit with our “How to Prepare for Your Follow-Up Consultation” PDF.
If your COPD is well controlled, your treatment may stay the same—or be reduced (called "stepping down") to the lowest dose that still keeps your symptoms under control.
If you experience persistent breathlessness or you have recurrent flare-ups, your GP will evaluate your smoking status and exposure to lung irritants, whether you're using your inhaler the right way, and whether you are able to stick to the treatment plan. Your lung function may be tested again. All of this helps guide the next steps in your treatment. That might mean switching to a different inhaler, adding another medication, or adjusting your current dose (called “stepping-up”) to better manage your symptoms. Your GP may also suggest that you attend a pulmonary rehabilitation programme (depending on your healthcare system) or refer you to a lung specialist, also known as a pulmonologist or respiratory physician. Pulmonary rehabilitation is a programme designed to improve your lung health and physical fitness. It combines exercise training with education about your condition and often involves different healthcare providers working together in a multidisciplinary team.
If you’ve had a COPD flare-up that you managed at home with your rescue medications, you should see your GP as soon as possible—ideally within two days of starting the rescue pack, or sooner if your symptoms get worse despite treatment. If your flare-up required a visit to the emergency room or a hospital stay, you should book a follow-up appointment with your GP within two days after you are discharged. This allows your GP to review your treatment and help reduce the risk of future flare-ups.
If your symptoms haven’t improved after a reasonable amount of time—even after your treatment plan has been adjusted—and you’ve been taking your medication correctly and on time, it’s time to see a lung specialist. In some countries, you may need a referral from your GP to make that appointment.
Another reason to see a specialist is if your GP is unsure whether COPD is the cause of your symptoms. If the diagnosis is unclear, more detailed testing may be needed. A lung specialist can confirm whether you have COPD or if another condition might be responsible. This helps ensure you receive the right treatment.
If you experience frequent flare-ups, or if you’ve had a serious flare-up that required hospitalisation, you will also be referred to a lung specialist. Depending on the results of your tests, you may need more specialized treatment. For people with severe COPD, the lung specialist may consider lung volume reduction. This can be done either by placing small one-way valves in the airways (called endobronchial valves) or through traditional surgery. Some people may also qualify for advanced treatments such medications by injection (biologics) or, in rare cases, a lung transplant. If you haven’t already been offered a pulmonary rehabilitation programme, your lung specialist can recommend this as well.
If you show signs of other health conditions that often occur alongside COPD—called comorbidities—you may also be referred to a different type of specialist. For example, you might need to see a heart specialist (cardiologist), a doctor who treats hormone and gland problems such as diabetes (endocrinologist), or an ear, nose, and throat (ENT) doctor.
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