Hospitals have been advised to refer patients with signs of COPD on a chest X-ray or CT scan that was performed for a different reason back to primary care for respiratory review.
New NICE guidelines on COPD have said that chest X-rays and CT scans are accurate tests for people who would go on to test positive for COPD on spirometry, and that patients who undergo scans for other purposes but who are found to have signs of airways disease, should be referred back to primary care for a respiratory review and spirometry testing to assess for COPD.
NICE says they expect a ‘small number of additional referrals for spirometry’, but that this will have minimal resource impact.
The update also amends indications for LABA use, with LABAs recommended for those with COPD confirmed on spirometry and who remain breathless after using a SABA and having non-pharmacological options exhausted.
This should be combined with a LAMA or inhaled corticosteroid depending on whether the patient has asthmatic features that indicate they may respond to steroids.
Patients using a long-acting bronchodilator outside of the NICE recommendations can continue until you both agree that it is an appropriate time to change.