Less than 20% Receive Education About Monitoring a COPD Flare-up

Results of Study Show Need for a COPD Flare-up Action Plan

Less than 1 of 5 patients with COPD received information from their doctors on how to self-monitor for signs of an impending COPD flare-up according to Anja Frei, Ph.D., of the University of Zurich. Dr. Frei presented these findings at the International Conference of the European Respiratory Society in London. A flare-up means an increase in cough, mucus production, and/or more short of breath. About 2/3 of flare-ups are due to a chest infection (bacterial or viral), while about 1/3 are due exposure to air pollution. The medical word for a COPD flare-up is an exacerbation. 
Photo on right shows acute bronchitis with yellow mucus inside the airway

Photo on right shows acute bronchitis with yellow mucus inside the airway. This can cause a COPD flare-up.

  Of 317 individuals with COPD living in Switerzerland who were surveyed,  just 53 remembered ever being told to monitor their own symptoms. About 36% recalled being given instructions to change medications in case of deteriorating breathing. 29% of those COPD took action when a flare-up occurred; some called their primary care provider, some used short-acting albuterol inhaler for relief, and others avoided aggravating situations.
Primary care providers discussing Action Plan for COPD flare-up

Primary care providers discussing Action Plan for COPD flare-up

According to Claudia Steurer-Stey, M.D., “We have a lot of work to do in education of these patients. The general practioner who sees the majority of their patients is a very important target of our work so they can improve the quality of primary care.” My Comments: All those with COPD should have a written action plan for what to do if/when they an experience a COPD flare-up. Here is a Simple COPD Action Plan if You Have a Flare-up ♦ If you are more short of breath, use albuterol sulfate and/or ipratropium bromide inhalers every 2 – 4 hours as needed Albuterol sulfate – brand names are ProAir, Proventil, and Ventolin Ipratropium bromide – brand name is Atrovent Combination of albuterol sulfate and ipratropium bromide – brand names are Combivent Respimat and DuoNeb solution (in nebulizer) ♦ If you cough up yellow or green mucus, call or see your health care provider to ask if an antibiotic is appropriate. ♦ If use of albuterol sulfate and/or ipratropium bromide does not help improve your breathing difficulty, call or see your health care provider to ask if prednisone is appropriate. ♦ If you cannot speak in full sentences or cannot fall asleep at night because of breathing difficulty, call or see your health care provider, go to an Urgent Care center, or go to the nearest Emergency Department.        

Donald A. Mahler, M.D. is Emeritus Professor of Medicine at Geisel School of Medicine at Dartmouth in Hanover, New Hampshire. He works as a pulmonary physician at Valley Regional Hospital in Claremont, NH, where he is Director of Respiratory Services.