The term chronic obstructive pulmonary disease (COPD) is used as an umbrella term for several respiratory conditions, including chronic bronchitis, emphysema and chronic asthma in which previously reversible airways disease loses some (or all) of its reversible element. Exacerbations of COPD are often underdiagnosed by clinicians and under-reported by patients but they have a significant impact on morbidity and mortality. Clinicians must be able to recognise and treat exacerbations promptly and effectively, as well as provide patients and carers with education on self-management of exacerbations where required. The NICE guidelines for managing COPD state that any patient who is at risk of an exacerbation should be given self-management advice that encourages them to respond promptly to the symptoms of an exacerbation.1
The typical symptoms of COPD include dyspnoea and a productive cough and these will be present on most days for many people. An exacerbation is an acute and sustained worsening of these symptoms - more cough, more phlegm (or more purulent phlegm) and more shortness of breath - which is above and beyond the individual's normal symptoms, and which requires an adjustment to the regular treatment regimen.2
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