Chronic Obstructive Pulmonary Disease (COPD) is an umbrella term used to describe chronic lung diseases that cause limitations in lung airflow. COPD affects mainly older people and includes conditions such as emphysema and chronic bronchitis. It can lead to mild or severe shortness of breath that is not fully reversible with the use of medicines.

Learning objectives

After reading this article, pharmacists should be able to:

  • Describe the evidence and rationale behind triple therapy in COPD
  • Assess patients with COPD likely to benefit from triple therapy
  • Evaluate risk of pneumonia associated with inhaled corticosteroid use in patients with COPD
  • Identify the role of the pharmacist in supporting people on triple therapy for COPD.

Competencies (2016) addressed: 1.1, 1.4, 1.5, 2.1, 2.2, 2.3, 2.4, 3.1, 3.2, 3.3, 3.5.

Case scenario

Louise is a 62-year-old female with COPD who was diagnosed more than 10 years ago. She has a 20 pack/year smoking history and has tried to quit smoking many times. She is moderately overweight with a body mass index (BMI) of 28, and has mild hypertension and episodic gastro-oesophageal reflux disease (GORD).

The patient is currently taking a long-acting muscarinic antagonist (LAMA)/ long-acting beta2-agonist (LABA). She has had 2 exacerbations in the past 12 months, which were treated with antibiotics and oral steroids. Louise is experiencing breathlessness with an ongoing cough and producing large amounts of sputum. She reports low levels of physical activity due to her symptoms.

Is it time to treat this patient using a stepwise approach COPD to triple therapy?

Test your knowledge on this article’s assessment questions here to earn up to 1.5 Group 2 CPD credits.