This one-on-one education visit with a trained facilitator provides an interactive environment for GPs to refresh their knowledge of current evidence and best practice in the diagnosis and management of chronic obstructive pulmonary disease (COPD). This includes using spirometry to diagnose COPD, using a stepwise approach to manage COPD, choosing inhaled COPD medicines based on potential benefits, safety profile and patient preference, and considering patient-related factors when prescribing inhaled medicines for patients.
Relevance to General Practice
Symptom-based COPD diagnosis in primary care is unreliable, and may not clearly exclude asthma. It can be difficult to distinguish between asthma and COPD, especially in older people and smokers. Spirometry, alongside clinical presentation, is the recommended standard for confirming diagnosis of COPD, excluding asthma and assessing severity prior to commencing certain treatment. Rates of spirometry use are growing but there is still potential underuse, and when used, it may be conducted sub-optimally.
Recently, many new COPD medicines have been released, leading to confusion about medicines, treatment regimen and PBS listings, with potential for unintended treatment duplication, and early use of medicines incongruent to the disease severity.
Most patients do not use their inhaler correctly and many may not be adhering to their COPD treatment. Conversely, health professionals may not be demonstrating inhaler technique leading to unnecessary treatment escalation and adverse effects.
- Describe the importance of spirometry in the diagnosis of COPD, and prior to commencing an ICS+LABA FDC.
- Utilise the Stepwise Management of Stable COPD chart to implement a systematic approach to achieve symptom control in patients.
- Choose inhaled medicines to treat COPD based on potential benefits, safety profile and patient preference.
- Describe and discuss with patients the key considerations that may influence choice of inhaler device.
Domains of General Practice
D1. Communication skills and the patient-doctor relationship
D2. Applied professional knowledge and skills
D3. Population health and the context of general practice
D4. Professional and ethical role
D5. Organisational and legal dimensions
Curriculum Contextual Units
- Adult health
- Care of older people
- Children and young people health