Chair, Reynold A. Panettieri, Jr., MD, prepared useful Practice Aids pertaining to chronic obstructive pulmonary disease for this CME/MOC/NCPD activity titled “Improving Adherence to Evidence-Based Guidelines for the Diagnosis and Management of COPD: Practical Strategies for the Healthcare Team to Optimize Patient Care.” For the full presentation, downloadable Practice Aids, and complete CME/MOC/NCPD information, and to apply for credit, please visit us at https://bit.ly/3oqLpOu. CME/MOC/NCPD credit will be available until February 14, 2022.

1. CAPTURE Instrument: COPD Assessment in Primary Care To Identify
Undiagnosed Respiratory Disease and Exacerbation Risk1
Full abbreviations, accreditation, and disclosure information available at PeerView.com/NBT40
1. Martinez FJ et al. Am J Respir Crit Care Med. 2017;195:748-756.
Please answer each question No Yes
1. Have you ever lived or worked in a place with dirty or polluted air, smoke, second-hand smoke, or dust?  
2. Does your breathing change with seasons, weather, or air quality?  
3.
Does your breathing make it difficult to do things such as carry heavy loads, shovel dirt or snow, jog,
play tennis, or swim?
 
4. Compared with others your age, do you tire easily?  
5.
In the past 12 months, how many times did you miss work, school, or other activities because of a cold,
bronchitis, or pneumonia?
  
For Clinical Use No Yes
PEF, L/min (Recommended for scores ≥2; best of three tests)
Men: 350 L/min  
Women: 250 L/min  
0 1 ≥2

2. American Lung Association:
My COPD Action Plan1
Full abbreviations, accreditation, and disclosure information available at
PeerView.com/NBT40
It is recommended that patients and physicians/healthcare providers
complete this action plan together.
This plan should be discussed at each physician visit and updated as needed.
The green, yellow, and red zones show symptoms of COPD. The list of symptoms is not comprehensive,
and you may experience other symptoms. In the “Actions” column, your healthcare provider will recommend
actions for you to take based on your symptoms by checking the appropriate boxes. Your healthcare provider
may write down other actions in addition to those listed here.
a
The American Lung Association recommends that providers select this action for all patients.
1. https://www.lung.org/getmedia/c7657648-a30f-4465-af92-fc762411922e/fy20-ala-copd-action-plan.pdf.
Yellow Zone: I am having a bad day or a COPD flare Actions
• More breathless than usual
• I have less energy for my daily activities
• Increased or thicker phlegm/mucus
• Using quick-relief inhaler/nebulizer more often
• Swelling of ankles more than usual
• More coughing than usual
• I feel like I have a “chest cold”
• Poor sleep and my symptoms woke me up
• My appetite is not good
• My medicine is not helping
 Continue daily medication
 Use quick-relief inhaler every hours
 Start an oral corticosteroid(specifyname,dose,andduration)
 Start an antibiotic (specifyname,dose,andduration)
 Use oxygen as prescribed
 Get plenty of rest
 Use pursed-lip breathing
 Avoid cigarette smoke and inhaled irritants at all timesa
 Call provider immediately if symptoms don’t improvea

Red Zone: I need urgent medical care Actions
• Severe shortness of breath even at rest
• Not able to do any activity because of breathing
• Not able to sleep because of breathing
• Fever or shaking chills
• Feeling confused or very drowsy
• Chest pains
• Coughing up blood
 Call 911 or seek medical care immediatelya
 While getting help, immediately do the following:
Green Zone: I am doing well today Actions
• Usual activity and exercise level
• Usual amounts of cough and phlegm/mucus
• Sleep well at night
• Appetite is good
 Take daily medicines
 Use oxygen as prescribed
 Continue regular exercise/diet plan
 Avoid cigarette smoke and inhaled irritants at all timesa


3. American Lung Association:
My COPD Management Plan1
Full abbreviations, accreditation, and disclosure information available at
PeerView.com/NBT40
It is recommended that patients and physicians/healthcare providers complete this management plan
together. This plan should be discussed at each physician visit and updated as needed.
Name:
Emergency contact:
Physician/healthcare provider name:
Type or Description of Medicines Name of Medicine How Much to Take When to Take
Date:
Phone number:
Phone number:
Flu vaccine:
Pneumococcal conjugate vaccine (PCV13)
 Yes  No
Pneumococcal polysaccharide vaccine (PPSV23)
 Yes  No
 Advise: Firmly recommend quitting smoking
 Assess readiness to quit
 Encourage to pick a quit date
 Assist with a specific cessation plan that can include materials, resources, referrals, and aids
 Anemia
 Diabetes
 Osteoporosis
 Anxiety/panic  Arthritis Blood clots Cancer Depression
 GERD/acid reflux  Heart disease High blood pressure Insomnia Kidney/prostate
 Other:
 Discuss use of medications, if appropriate:
 Freedom From Smokinga
Lung.org/ffs
 Lung HelpLine 1-800-LUNG USA
Smoking status:  Never  Past  Current
Exercise plan:  Yes  No
Diet plan:  Yes  No
 Walking  Other
min/day days/week
Quit smoking plan:  Yes  No
Date received:
Date received:
Date received:
Pulmonary rehabilitation:
 Yes  No
Goal Weight
Next flu vaccine due:
Next PCV13 vaccine due:
Next PPSV23 vaccine due:
Lung Function Measurements
Medications for COPD
My Quit Smoking Plan
General Information
Resting: Increased activity: Sleeping:
Oxygen
Advanced directives (including healthcare power of attorney):
Advanced Care and Planning Options
Other Health Conditions
a
The American Lung Association recommends that providers select this action for all patients.
1. https://www.lung.org/getmedia/c7657648-a30f-4465-af92-fc762411922e/fy20-ala-copd-action-plan.pdf.