
![]()
- > 40 years of age
- History of smoking
- Presenting with symptoms of COPD, including:
- Chronic cough
- Sputum production
- Dyspnea
- Wheezing3, 4
Identifying COPD early is important because COPD is progressive:4

Ask your patients if they smoke (or used to smoke) and assess them for any COPD signs and symptoms.
A clinical diagnosis of COPD is confirmed with spirometry.4
Patient Profile: Rita R.
“When I climb the stairs, I have to take a break to catch my breath.”
Age: 53
Smoking History: 22 pack-years*
Current Rx: No current medication
Subjective: Reports a morning cough and recently has noticed shortness of breath during activity. Currently smoking.
Objective:
- Auscultation reveals clear breath sounds bilaterally
- Spirometry: postbronchodilator FEV1=67% predicted; FEV1/FVC=63%
- Rita is a moderate COPD patient per GOLD guidelines


Once you have made a diagnosis of COPD, be sure to assess the patient's activity level and symptoms at every visit.
- Have you been as active since your last visit?
- How has shortness of breath affected your activities?
- Has your shortness of breath worsened, improved, or stayed the same?
- Have any other symptoms worsened — such as coughing or wheezing?
- Have you experienced any new symptoms?

The Global Initiative for Obstructive Lung Disease (GOLD) has developed detailed guidelines for the treatment of COPD.

![]()
- COPD is defined as an FEV1/FVC<0.70
- Spirometric readings should be conducted following administration of bronchodilator to accurately diagnose and assess COPD severity
- Short acting bronchodilators are initially given as needed
- Long acting bronchodilators should be inititated as maintence therapy when airflow limitation worsens and/or symptoms become persistent
- Long-term oxygen should be added for patients with Stage IV (very severe) COPD
- - Surgical treatments should also be considered in these patients
- - Inhaled glucocorticosteriods should be reserved for Stage III or Stage IV patients with repeated exacerbations
![]()
- The only long-acting anticholinergic bronchodilator6, 7
- Provides superior sustained predose FEV1 improvement in patients with mild COPD5
SPIRIVA is broadly available to your patients who need it:1
- Covered under most Medicare Part D plans
- Broad formulary coverage, and is at the lowest branded co-pay tier with major insurers




