Respiratory and sleep medicine
Chronic obstructive pulmonary disease
Spirometric diagnosis, GOLD 2026 ABE assessment, stepwise inhalers, exacerbation care, oxygen and NIV criteria, and the interventions that improve survival.
Tier 1Condition
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- COPD is persistent airflow limitation (post-bronchodilator FEV1/FVC below 0.7) with chronic symptoms, from smoking in most Australians, also biomass, occupational dust and alpha-1 antitrypsin deficiency.
- Australia's COPD-X Plan (V2.78, December 2025; its regular evidence updates are paused during a transition) and GOLD 2026 guide care.
- GOLD 2026 lowered the bar: a single moderate exacerbation now places a patient in group E and is a reason to escalate.
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Sources
- The COPD-X Plan: Australian and New Zealand guidelines for the management of chronic obstructive pulmonary diseaseAU/NZLung Foundation Australia and Thoracic Society of Australia and New Zealand, V2.78, December 2025
- Global Strategy for the Diagnosis, Management and Prevention of COPD, 2026 reportGlobal Initiative for Chronic Obstructive Lung Disease (GOLD), 2026
- Thoracic Society of Australia and New Zealand position statement on acute oxygen use in adults ("Swimming between the flags")AU/NZThoracic Society of Australia and New Zealand (Respirology), 2022
- PBS medicine status: mepolizumab (Nucala) for uncontrolled COPD, listed 1 September 2026AU/NZPharmaceutical Benefits Scheme, 2026
- PBS medicine status: dupilumab (Dupixent) for uncontrolled COPD (recommended March 2026, listing inactive as at 1 November 2026)AU/NZPharmaceutical Benefits Scheme, 2026
- Effect of home noninvasive ventilation with oxygen therapy vs oxygen therapy alone on hospital readmission or death after an acute COPD exacerbation (HOT-HMV)JAMA (Murphy et al), 2017
- Effect of regular, low-dose, extended-release morphine on chronic breathlessness in COPD (BEAMS)JAMA (Ekström et al), 2022
- McDonald CF et al. Thoracic Society of Australia and New Zealand clinical practice guideline on adult home oxygen therapy. Respirology 2024;29(9):765-84AU/NZThoracic Society of Australia and New Zealand (Respirology), 2024
- AusPAR: roflumilast (Daxas), Nycomed Pty Ltd. Application withdrawn 16 November 2011AU/NZTherapeutic Goods Administration, 2011
- Long-term oxygen therapy for 24 or 15 hours per day in severe hypoxemia (REDOX)New England Journal of Medicine (Ekström et al), 391:977-88, 2024
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Deploy to Cloudflare on push to main