P9. Regular review

Regular review, with objective measures of function and medication review, is recommended in the hope that this may reduce complications and the frequency or the severity (or both) of exacerbations and admissions to hospital. Please see comments in section D.

A prospective trial in the primary care setting (Abramson 2010) randomised patients who had been prescribed inhaled medication to a) three monthly review and spirometry, b) usual care and spirometry before and after trial and c) usual care. This study did not show any significant improvement in quality of life or other health outcomes. Possible explanations for the negative results include limited power, few events and inclusion of doctor diagnosed obstructive lung disease as opposed to spirometry defined patients. Spirometry remains the gold standard for establishing the diagnosis of COPD.