3 evidence-based strategies for people living with chronic obstructive pulmonary disease

The Bottom Line

  • Chronic obstructive pulmonary disease (COPD) is a lung disease that results in breathing problems and can interfere with daily activities of living.
  • Quitting smoking, taking certain medications, and using home or community-based pulmonary rehabilitation may be helpful strategies for folks living with COPD.
  • Discuss with your healthcare team how to safely try these evidence-based strategies.

Difficulty breathing is a hallmark of chronic obstructive pulmonary disease (COPD), a potentially debilitating condition that is listed as the third leading cause of death across the globe (1). Living with COPD can be very challenging. Luckily, there are several evidence-based strategies that may improve symptoms and quality of life!


Click on the links below to learn more.


1. Quitting smoking

Be a quitter! Quitting smoking, no matter how long you have been smoking for, is important. Quitting can help improve symptoms and quality of life and increase survival in people living with COPD (2;3). Research shows that a combination of behavioural treatments and drug treatments might be the best strategy for helping people living with COPD quit smoking. Effective treatments include cognitive behavioural therapy plus the medication bupropion or counseling plus the medication varenicline. The safety of drug treatments should be kept in mind, as some studies have found that drugs like buproprion and varenicline may have some negative side effects including insomnia, dry mouth, and general discomfort (3).


2. Medications

Research shows that using phosphodiesterase 4 (PDE4) inhibitors may help to improve lung function and reduce the likelihood of episodes of coughing and breathlessness in people with stable, moderate to very severe COPD. PDE4 inhibitors, including roflumilast and cilomilast, come in tablet form and are taken orally. More research is needed on the long-term effects of these medications. Known side effects include diarrhea, nausea, headache, vomiting, and abdominal pain (4).


3. Home or community-based pulmonary rehabilitation

Research shows that home or community-based pulmonary rehabilitation is more effective in improving breathing and quality of life than no treatment in people with COPD. Moreover, it is as effective as hospital-based rehabilitation. Pulmonary rehabilitation is a strategy that combines exercise, education, and behavioural change (5).


Looking for strategies to add to your COPD treatment and management plan? Behavioural treatments, certain medications, and home or community-based pulmonary rehabilitation may be effective standalone or combined strategies. Consult your healthcare team about whether these strategies are appropriate for you and how you can safely integrate them into your treatment and management plan.


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References

  1. Statistics Canada. Chronic obstructive pulmonary disease (COPD), 35 years and over. [Internet] 2022. [cited July 2023]. Available from https://www150.statcan.gc.ca/t1/tbl1/en/tv.action?pid=1310009619.
  2. World Health Organization. Chronic obstructive pulmonary disease (COPD). [Internet] 2023. [cited July 2023]. Available from https://www.who.int/news-room/fact-sheets/detail/chronic-obstructive-pulmonary-disease-(copd).
  3. Wei X, Guo K, Shang X, et al. Effects of different interventions on smoking cessation in chronic obstructive pulmonary disease patients: A systematic review and network meta-analysis. Int J Nurse Stud. 2022; 136:104362. doi: 10.1016/j.ijnurstu.2022.104362.
  4. Janjua S, Fortescue R, Poole P. Phosphodiesterase-4 inhibitors for chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2020; 5:CD002309. doi: 10.1002/14651858.CD002309.pub6.
  5. Neves LF, Reis MH, Goncalves TR. Home or community-based pulmonary rehabilitation for individuals with chronic obstructive pulmonary disease: A systematic review and meta-analysis. Cad Saude Publica. 2016; 32(6). doi: 10.1590/0102-311X00085915.  

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