What must be assessed before deciding to escalate therapy for COPD?

The assessment of inhaler technique and adherence is crucial before deciding to escalate therapy for Chronic Obstructive Pulmonary Disease (COPD). Proper inhaler technique ensures that the medication is delivered effectively to the lungs, allowing for optimal therapeutic benefits. If a patient is not using their inhaler correctly, or if they are not adherent to the prescribed regimen, the perceived inadequacy of treatment may not be due to the medication itself but rather to these user-related factors.

Evaluating adherence helps identify whether the patient is taking their medication as prescribed, which can significantly affect their COPD management. If adherence is low or the inhaler technique is poor, addressing these issues can potentially improve the patient's condition without necessitating a change in therapy. Recognizing and correcting these problems should be a priority before considering more aggressive treatment options, which might carry greater risks or side effects.

While factors like lung capacity, oxygen levels, smoking history, previous treatments, comorbid conditions, and age are also important in the overall management of COPD, they are secondary in this context. Ensuring that the foundational aspects of medication use—technique and adherence—are being managed appropriately is essential for effective treatment escalation.