One proposed definition of COPD stability needs only information collected at a routine review: any moderate or severe exacerbation since last time, the COPD Assessment Test (CAT) score, and FEV1.
If there has been no exacerbation and neither CAT nor FEV1 has worsened, the patient is stable. If there has been a moderate or severe exacerbation, or a clinically meaningful worsening in CAT or FEV1, review inhaler technique, adherence, smoking, rehabilitation and treatment step before escalating.
- Ask about every course of steroids or antibiotics and every emergency visit since the last review.
- Record the CAT score at each visit; it takes two minutes.
- Repeat spirometry at least yearly and compare with the patient's own baseline.
- Check inhaler technique before stepping up therapy.
Why it matters
It turns 'how are you doing?' into a measurable target that predicts future risk.
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