Chronic obstructive pulmonary disease (COPD) stays with you for life, and it usually gets worse over time. But with lifestyle changes and medication, you can slow it down and ease your symptoms. To do this, you and your doctor will set treatment goals and work together to reach them.
“Living with a chronic disease can be frustrating and challenging, so achieving goals in the short term or long term can help patients feel like they are managing the disease,” says Zachary Greenstein, MD, a pulmonary and critical care doctor at Northwell Lenox Hill Hospital.
Which COPD Treatment Goals Are Most Important?
First, you and your doctor will focus on keeping your COPD in check.
“I consider the key COPD treatment goals to be a combination of stabilizing disease progression and reducing anything that can make the condition worse,” says Samuel Cohen, MD, who leads the pulmonary function laboratory at Cedars-Sinai in Los Angeles.
This will help you reach two more critical treatment goals: reducing COPD flare-ups and avoiding hospitalization.
Flare-ups or exacerbations can last days or even weeks, and treating them often requires a hospital stay. According to a 2020 study in the International Journal of Chronic Obstructive Pulmonary Disease, such hospitalizations boost your risk of dying from COPD.
Another critical goal Greenstein has his patients aim for: “Functioning effectively in their activities of daily living as symptom-free as possible,” he says.
How Do You Reach Your COPD Treatment Goals?
While the goal for everyone with COPD is to keep symptoms in check, the way you get there is personal. You and your doctor will work together to develop a plan that works for you.
“Everyone is different in terms of both what they prioritize and what is achievable, depending on the severity of COPD,” says Cohen
One common priority for people with COPD: quitting smoking. Smoking speeds up the damage COPD does to your lungs, and stopping is the most important way to improve your outcome. Yet nearly 40% of people with COPD still smoke, according to the CDC. That speaks to just how hard it can be to kick the habit.
“It’s common to have to try more than once to be successful,” Cohen says.
Pulmonary rehabilitation (PR) can make it easier to reach your goals. Typically involving two to three weekly sessions over a few weeks, pulmonary rehabilitation:
- Teaches you techniques to help you breathe more easily
- Improves your ability to be physically active while limiting shortness of breath
- Teaches you healthy nutrition
- Offers psychological counseling and community
How Do You Track Your Progress?
To stay on track with your goals, it’s important to measure your progress. Lung function tests, for example, assess how serious your COPD is and how it’s changed over time. But such tests don’t tell the whole story, Greenstein says.
“I would encourage patients to use their symptoms as the best tool to monitor progress towards a goal,” he says. “Writing things down in a symptoms journal can be a good way to compare one time point to another.”
He gives the following example: Say you’ve set an exercise goal of walking 1 mile. But at the beginning, you feel short of breath after walking a block. Don’t give up. Stick with your walking program and, at regular intervals, note how much farther you can walk before you feel short of breath.
How Do You Stay Motivated?
Finding things that inspire you to stay on track can help you meet your treatment goals. Talk with your doctor about the things you like to do or want to try. Perhaps you want to be able to play with your grandkids, go on a hike, take a Pilates class, or travel.
“Finding those things that matter most can help the patient see an attainable outcome,” says Greenstein. “Frequently, that is enough to provide the intrinsic motivation to stick to their treatment plan.”
How Do You Handle Setbacks?
Achieving your treatment goals will challenge you. Don’t expect to succeed every day. As Cohen says about smoking, you may have to try more than once to achieve success. And you may have to make adjustments to your expectations.
“There can be a lot of ups and downs with any medical problem, and COPD is no exception,” says Cohen.
It’s important to understand the stage of your COPD and to plan for potential setbacks, he says. This helps you keep the long term in mind.
A setback, such as a flare-up, can be disheartening. But, says Greenstein, your doctor can find out what caused it and guide you through the challenge it presents. Then, you and your doctor can decide the best ways to get you back on track toward your treatment goals.
“The best treatment plan is the one that the patient can adhere to,” says Greenstein. “And the treatment plan will change over the course of the disease, sometimes requiring higher levels of treatment and sometimes lower levels. The mantra as it pertains to COPD management is ‘review, assess, adjust.’”
Show Sources
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SOURCES:
Zachary Greenstein, MD, pulmonary and critical care doctor, Northwell Lenox Hill Hospital, New York City.
Samuel Cohen, MD, pulmonologist, Cedars-Sinai, Los Angeles.
Mayo Clinic: “COPD.”
Cleveland Clinic: “Preventing COPD Exacerbations and Flare-Ups.”
International Journal of Chronic Obstructive Pulmonary Disease: “Management and Risk of Mortality in Patients Hospitalised Due to a First Severe COPD Exacerbation.”
CDC: “Smoking and COPD.”
