Chronic Obstructive Pulmonary Disease in Over 16s: Diagnosis and Management (NICE NG115)

NICE NG115 provides comprehensive guidance on the diagnosis and management of COPD including spirometry, inhaler therapy, pulmonary rehabilitation, and exacerbation management.

Key Recommendations

• Confirm diagnosis with spirometry: post-bronchodilator FEV1/FVC <0.7
• Offer smoking cessation support to all current smokers — most important intervention
• Mild-moderate (FEV1 ≥50%): SABA or SAMA as needed. If persistent dyspnoea, add LABA or LAMA
• Triple therapy (ICS/LABA/LAMA) for those with ≥2 exacerbations per year or frequent symptoms
• Pulmonary rehabilitation for all with MRC grade 3+
• Annual influenza vaccine and one-off pneumococcal vaccine for all
• Self-management plan including rescue pack (prednisolone + antibiotic) for eligible patients