At-home treatment options for chronic obstructive pulmonary disease (COPD)

At-home treatment options for chronic obstructive pulmonary disease (COPD) focus on reducing symptoms, preventing exacerbations, and improving quality of life. Key components include:

Smoking cessation is the most effective intervention to slow disease progression and reduce mortality. Both behavioral support and pharmacotherapy (nicotine replacement, bupropion, varenicline) are recommended.[1-3]
Vaccinations against influenza and pneumococcus are essential to reduce the risk of respiratory infections and exacerbations.[1-3]
Avoidance of environmental exposures (e.g., air pollutants, occupational irritants) is advised to minimize symptom triggers.[1-2]
Pharmacologic therapy centers on inhaled bronchodilators: long-acting muscarinic antagonists (LAMA) and/or long-acting beta-agonists (LABA) are first-line for maintenance. Inhaled corticosteroids (ICS) are added for patients with frequent exacerbations. Proper inhaler technique and adherence are critical for efficacy.[1][3-5]
Pulmonary rehabilitation (PR), including home-based or unsupervised programs, improves dyspnea, exercise tolerance, and quality of life. Home-based PR is effective when in-person programs are not feasible.[1][3][6]
Long-term oxygen therapy (LTOT) is indicated for patients with severe resting hypoxemia (PaO₂ ≤ 55 mmHg or ≤ 60 mmHg with evidence of tissue hypoxia) and should be administered for ≥15 hours/day.[3-4]
Self-management education (action plans for exacerbations, breathing exercises, energy conservation, and recognition of symptom worsening) is recommended to empower patients and reduce hospitalizations.[1][3][7]
In select patients, non-invasive ventilation and advanced therapies may be considered, and comorbidities should be managed as part of comprehensive care.[3][8]

The following algorithm visually summarizes the stepwise approach to at-home COPD management, including lifestyle, pharmacologic, and non-pharmacologic interventions:

Figure 2. Algorithm for the Evaluation and Treatment of Persons with COPD or at Risk for COPD.

Update on Clinical Aspects of Chronic Obstructive Pulmonary Disease. N Engl J Med. September 25, 2019.

Used under license from The New England Journal of Medicine.

Helpful

References

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