This guidance is a partial update of NICE clinical guideline 12 (published February 2004) and replaces it.

An estimated 3 million people have chronic obstructive pulmonary disease (COPD) in the UK. About 900,000 have diagnosed COPD and an estimated 2 million people have COPD which remains undiagnosed[1]. Most patients are not diagnosed until they are in their fifties.

The guideline will assume that prescribers will use a drug's summary of product characteristics to inform decisions made with individual patients.

New recommendations have been added on spirometry, assessment of prognostic factors, and to the section on inhaled therapy (which now incorporates the previously separate sections on inhaled bronchodilators, inhaled corticosteroids and inhaled combination therapy).

Recommendations are marked as [2004], [2007], [2010] or [new 2010].

  • [2004] indicates that the evidence has not been updated and reviewed since the original guideline.

  • [2004, amended 2010] applies to one specific recommendation where the evidence has not been reviewed since the original guideline but it has been updated because of GDG consensus that it is out of date or no longer reflects clinical practice.

  • [2007] applies to two specific recommendations that were developed as part of a technology appraisal in 2007.

  • [2010] indicates that the evidence has been reviewed but no change has been made to the recommendation.

  • [new 2010] indicates that the evidence has been reviewed and the recommendation has been updated or added.

[1] Healthcare Commission (2006) Clearing the air: a national study of chronic obstructive pulmonary disease. London: Healthcare Commission.

  • National Institute for Health and Care Excellence (NICE)