The ACP/ACCP/ATS has issued updated guidelines for the management of patients with copd. The major recommendations include: treat only symptomatic patients regardless of stage, use spirometry to stage symptomatic patients, patients with an FEV1<60% should be treated with monotherapy (either long acting beta-agonist or long-acting anti-cholinergic) or dual therapy (combining long acting-beta agonist, steroid, or anti-cholinergic), and pulmonary rehab for all those with FEV1<50% or symptoms. The full guidelines are available from the ACP (link)
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