An integrated approach to the medical treatment of chronic obstructive pulmonary disease

Comprehensive medical care of individuals with chronic obstructive pulmonary disease (COPD) requires a detailed evaluation of patients beyond the measurement of lung function. Symptoms should be determined in an objective manner, particular attention should be paid to a history of exacerbations, and the presence of comorbid conditions should be determined. Exercise capacity determined by a 6-minute walk distance can also be informative. Virtually all COPD therapies improve respiratory symptoms, lessen exacerbation frequency, and improve quality of life; selection of COPD pharmacotherapy should be individualized to each patient's symptom and exacerbation burden and their individual response to therapy over time.