The strongest predictor of the next exacerbation in COPD, asthma or bronchiectasis is the last one. Yet exacerbation history is often recorded vaguely, as 'occasional flares'.
Ask specifically: how many courses of antibiotics or oral steroids in the past 12 months, and how many hospital or emergency visits for the chest? Check the pharmacy or discharge records if the patient is unsure. Write the numbers down.
Those two numbers decide eligibility for biologics, long-term macrolides and pulmonary rehabilitation, and they tell you whether current treatment is working.
- Count antibiotic and oral steroid courses in the past 12 months
- Count emergency visits and admissions separately
- Check records where the history is uncertain
- Use the numbers to decide on escalation
Why it matters
Exacerbation history is the most useful risk marker in chronic airway disease and is often recorded too vaguely to use.
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