Review Article

Optimising pharmacological maintenance treatment for COPD in primary care

  • Primary Care Respiratory Journal (2010) 20, 3345 (2011)
  • doi:10.4104/pcrj.2010.00069
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Chronic obstructive pulmonary disease (COPD) is a multi-faceted disease that is a major cause of morbidity and mortality worldwide, and is a significant burden in terms of healthcare resource utilisation and cost. Despite the availability of national and international guidelines, and effective, well-tolerated pharmacological treatments, COPD remains substantially under-diagnosed and under-treated within primary care. As COPD is both preventable and treatable there is an urgent need to raise the awareness and profile of the disease among primary care physicians and patients. Increasing evidence suggests that initiation of long-acting bronchodilator treatment at an early stage can significantly improve the patient's long-term health and quality of life (QoL). Recent large-scale trials in COPD have confirmed the long-term benefits of maintenance treatment with long-acting bronchodilators. A wide range of benefits have been shown in selected patient groups including improved lung function and QoL, reduced exacerbations and, in some studies, delayed disease progression and improved survival. In this review, we consider recent developments in our understanding of COPD, including current and emerging pharmacological treatment options, and identify steps for optimising early diagnosis and pharmacological treatment of COPD within the primary care environment.

Author information


  1. Respiratory Research Unit, Peninsula Medical School, University of Plymouth, UK

    • Rupert Jones
  2. Gransdalen Legesenter, Gransdalen, Oslo, Norway

    • Anders Østrem


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Competing interests

RJ has been paid to take part in educational activities related to COPD for Altana, AstraZeneca, Boehringer Ingelheim (BI), GlaxoSmithKline (GSK), Novartis, Nutricia, Pfizer, TEVA, Tejin and Trinity Chiesi in the last 3 years. RJ is a consultant to the global emPOWER educational programme supported by Pfizer and BI.

AØ has been paid to take part in advisory boards related to COPD for BI, Pfizer and Nycomed. He has spoken at educational meetings financed by GSK, BI and Pfizer in the last 3 years. He is a consultant on the global emPOWER educational programme supported by Pfizer and BI.

Corresponding author

Correspondence to Rupert Jones.