COPD Management (2026 Updates)

COPD guidelines have changed—and if you’re managing COPD in primary care, there are a few updates worth knowing. In this episode, I walk through how to approach a patient with COPD at a routine visit, especially when you’re seeing them for the first time or inheriting their care from another provider. We’ll cover how to confirm the diagnosis with spirometry, how to think about GOLD 1–4 alongside the ABE assessment, and how the mMRC and CAT scores fit into your assessment. We’ll also talk about alpha-1 antitrypsin deficiency testing, blood eosinophils and inhaled corticosteroids, initial inhaler therapy, and what to monitor at follow-up. I also walk through the pieces of COPD management beyond medications—including smoking cessation, vaccinations, exercise and nutrition, pulmonary rehabilitation, and management of comorbidities. In this episode: 00:00 – Introduction + COPD guideline updates 01:03 – Approaching COPD management in primary care 01:53 – Confirming COPD with spirometry and FEV1/FVC 03:01 – Pre-COPD and PRISm 03:53 – GOLD 1–4 and the ABE assessment 05:12 – Using the mMRC and CAT scores 06:23 – What to assess at a COPD follow-up visit 07:50 – Alpha-1 antitrypsin deficiency testing 08:26 – Blood eosinophils and inhaled corticosteroids 09:37 – COPD management beyond inhalers 11:15 – Pulmonary rehabilitation and comorbidities 11:37 – SABA, SAMA, LABA, LAMA, and ICS 12:21 – Initial COPD treatment by GOLD ABE group 13:50 – Initial treatment for Groups A and B 14:35 – COPD follow-up and spirometry 15:04 – Chest imaging and lung cancer screening 15:46 – When to refer to pulmonology COPD cheat sheet + Digital NP Binder: realworldnp.com/binder For a full transcript and conversation chapters, visit the blog: https://www.realworldnp.com/blog/copd-management ______________________________ © 2026 Real World NP. For educational and informational purposes only, see https://www.realworldnp.com/disclaimer for full details. Hosted on Acast. See acast.com/privacy for more information.