The COPD-X Plan: Australian and New Zealand Guidelines …

1 The COPD-X Plan Version 2 63 (February 2021) 1 The COPD-X Plan: Australian and New Zealand Guidelines for the management of Chronic Obstructive Pulmonary Disease 2021 Current COPD Guidelines Committee Professor Ian Yang, MBBS(Hons), PhD, FRACP, Grad Dip Clin Epid, FAPSR, FThorSoc, Thoracic Physician, The Prince Charles Hospital and The University of Queensland, Brisbane, QLD (Co-Chair) Associate Professor Eli Dabscheck, MBBS, M Clin Epi, FRACP, Staff Specialist, Department of Respiratory Medicine, The Alfred Hospital, Melbourne, VIC (Co-Chair) Dr Johnson George, BPharm, MPharm, PhD, Grad Cert Higher Education, Senior Lecturer, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, VIC Dr Sue Jenkins, OAM, GradDipPhys, PhD, Physiotherapy Department, Sir Charles Gairdner Hospital; School of Physiotherapy and Exercise Science, Curtin University.

2 Institute for Respiratory Health, Perth, WA Professor Christine McDonald, AM, FAHMS, MBBS(Hons), PhD, FRACP, FThorSoc, Director, Department of Respiratory and Sleep Medicine, The Austin Hospital, Melbourne, VIC Professor Vanessa McDonald DipHlthScien (Nurs), BNurs, PhD, FThorSoc, Professor of Chronic Disease and Academic Clinical Nurse Consultant, The University of Newcastle and John Hunter Hospital, Newcastle, NSW Professor Brian Smith, MBBS, Dip Clin Ep & Biostats, PhD, FRACP, Staff Specialist, Bendigo Hospital (VIC) Professor Nick Zwar, MBBS, MPH, PhD, FRACGP, Executive Dean, Faculty of Health Sciences and Medicine, Bond University (QLD) Lung Foundation Australia Secretariat Support Ms Mearon O Brien, BPubH, Guidelines Manager, Lung Foundation Australia, Brisbane.

3 Adjunct Fellow, The University of Queensland, Brisbane Ms Kelcie Herrmann, BSpPath, General Manager Clinical Programs, Research and Innovation, Lung Foundation Australia, Brisbane Website Updates: Ms Mearon O Brien, Guidelines Manager, Lung Foundation Australia, Brisbane Literature Searches: Literature search strategy provided by Megan Neumann, Client Services Librarian at The Prince Charles Hospital, Brisbane These Guidelines have been developed and revised by Lung Foundation Australia and the Thoracic Society of Australia and New Zealand as part of a national COPD program. Correspondence: Lung Foundation Australia, PO Box 1949, Milton QLD 4064. The COPD-X Plan Version 2 63 (February 2021) 2 Past Committee Members Past Chairpersons Professor Michael Abramson, MBBS, BMedSc(Hons), PhD, FRACP, FAFPHM, Deputy Head, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC (Principal Author) (Chair: 2004-2014) Professor Alan J Crockett, PSM, MPH, PhD, FANZSRS Professor of Clinical Respiratory Physiology, Division of Health Sciences, University of South Australia.

4 Emeritus Fellow, Discipline of General Practice, School of Population Health, University of Adelaide, Adelaide, SA (Chair: 2003-2004) Past Committee Members Professor Michael Abramson, MBBS, BMedSc(Hons), PhD, FRACP, FAFPHM, Deputy Head, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC (Principal Author) (Chair: 2004-2014) Professor Alan J Crockett, PSM, MPH, PhD, FANZSRS Professor of Clinical Respiratory Physiology, Division of Health Sciences, University of South Australia; Emeritus Fellow, Discipline of General Practice, School of Population Health, University of Adelaide, Adelaide, SA (Chair: 2003-2004) Associate Professor David K McKenzie, PhD, FRACP, Director of Cardiac and Respiratory Services, South East Sydney Local Health District and Head of Department, Respiratory and Sleep Medicine, Prince of Wales Hospital, Randwick, NSW (Principal author)

5 Professor Peter A Frith, MBBS, FRACP, Professor in Respiratory Medicine, Flinders University and Repatriation General Hospital, Daw Park, SA Professor Norbert Berend, MD, FRACP, Director, Woolcock Institute of Medical Research, Royal Prince Alfred Hospital, Sydney, NSW Ms Jenny Bergin, BPharm, MPS, Pharmacist Consultant, Pharmacy Guild of Australia Dr Jonathan G W Burdon, MD, FRACP, Respiratory Physician, Department of Respiratory Medicine, St Vincent s Hospital, Melbourne, VIC Associate Professor Stephen Cala, PhD, FRACP, Respiratory Physician, and Head, Respiratory Investigation Unit, Gosford Hospital and University of Newcastle, NSW Professor Peter Gibson, MBBS, FRACP, Respiratory Specialist, John Hunter Hospital, Newcastle, NSW Professor Nicholas Glasgow, MBChB, MD, FRNZGP, FRACGP, FAChPM, Dean, Medicine and Health Sciences, College of Medicine, Biology and Environment, the Australian National University, Canberra, ACT Professor Christine Jenkins, AM, MD, FRACP, Thoracic Physician, Concord Hospital, Sydney, NSW Mr Ross Lisle, Consumer Representative, Toowoomba, QLD Professor Guy Marks, Australian Centre for Asthma Management, Sydney, NSW Dr Jitendra Parikh, MD, MPM, Royal Australian College of General Practitioners Professor Harold H Rea, MD, FRACP.

6 Academic Head of Medicine, South Auckland Clinical School, University of Auckland, New Zealand Mrs Marilyn Robinson, RN, Respiratory/Asthma Educator, Townsville Community Health Service, Townsville Health Services District, QLD Professor Julian A Smith, MS, FRACS, Professor, and Head, Department of Surgery, Monash University, and Head, Cardiothoracic Surgery Unit, Monash Medical Centre, Clayton, VIC Associate Professor Greg. Snell, MBBS, FRACP, Respiratory and lung transplant Physician, Department of Respiratory Medicine, Alfred Hospital, Melbourne, VIC Associate Professor Robin D Taylor, MD, FRCPC, Department of Respiratory Medicine, Dunedin School of Medicine, University of Otago, Dunedin, NZ Professor G Ian Town, DM, FRACP, Dean, Christchurch School of Medicine and Health Sciences, New Zealand Mr Marcus Weidinger, Pharmaceutical Society of Australia Dr Richard Wood-Baker, MBBS, DM, FRACGP, FRCP, MRCP[I], MEd, Director of Cardiorespiratory Medicine, Royal Hobart Hospital.

7 Honorary Fellow, Menzies Research Institute, Hobart, TAS The COPD-X Plan Version 2 63 (February 2021) 3 Other contributors Past and Present Associate Professor Jenny Alison, Physiotherapist Dr Guy Bannink, Staff Specialist Palliative Medicine Ms Kate Baumwol, Senior Speech Pathologist Mr Paul Cafarella, Psychologist Associate Professor Donald Campbell, Respiratory Physician Ms Nola Cecins, Physiotherapist Dr Belinda Cochrane, Staff Specialist Respiratory and Sleep Physician Dr Karen Detering, Respiratory Physician Dr Tanja Effing, Respiratory Scientist/ Epidemiologist Dr Michael Epton, Respiratory Physician Dr Nichola Gale, Senior Lecturer.

8 Physiotherapy/ Researcher Professor Charles Gilks, International Public Health Specialist Dr David Hart, Respiratory Physician Associate Professor Peter Holmes, Respiratory Physician Associate Professor Kylie Hill, Physiotherapist Dr Alice YM Jones, Physiotherapist; Honorary Professor; Adjunct Professor Ms Kim Jones, Research Assistant Dr Kirk Kee, Respiratory Physician Dr Jun (JK) Khoo, Specialist Respiratory and Sleep Disorders Physician Ms Leona Knapman, Exercise Physiologist Associate Professor John Kolbe, Respiratory Physician Ms Zoe Kopsaftis, Research Officer Dr Tom Kotsimbos, Respiratory Physician Dr Nicole Livermore, Senior Clinical Psychologist Ms Maria Loder, Respiratory Nurse Dr James Markos, Respiratory Physician Dr R Doug McEvoy, Respiratory and Sleep Physician Dr Renae McNamara, Physiotherapist Dr Ruth McKenzie, General Practitioner Associate Professor Lucy Morgan, Respiratory Physician Dr Shirley PC Ngai, Physiotherapist.

9 Assistant Professor Dr Cristino C Oliveira, Physiotherapist Dr Matthew Peters, Respiratory Physician Professor Philippa Poole, Senior Lecturer Professor Robert Pierce, Respiratory Physician (deceased) Associate Professor Robyn Richmond, Researcher Dr Jonathan Rutland, Respiratory Physician Professor Paul Seale, Respiratory Physician Associate Professor Natasha Smallwood, Respiratory Physician Ms Laura Smith, PhD Student Ms Sheree Smith, Respiratory Nurse Professor Greg Snell, lung transplant Physician Ms Gillian Syres, Research Fellow Mr Pieter Walker, Psychologist Conjoint Professor Peter Wark, Senior Staff Specialist Professor Trevor Williams, Respiratory & Sleep Medicine Physician Mr Jamie Wood, Senior Physiotherapist Cystic Fibrosis Prof Lisa Wood, Nutritional Biochemist Associate Professor Iven Young, Respiratory Physician Ms Juliet L Brown, BA(Hons)

10 , MLib, Former COPD Project and Guidelines Manager, Lung Foundation Australia, Brisbane The COPD-X Plan Version 2 63 (February 2021) 4 Table of Contents Current COPD Guidelines Committee .. 1 Past Committee Members .. 2 Other contributors Past and Present .. 3 Foreword .. 10 The origins of the COPD-X Guidelines .. 11 COPD-X Methodology .. 12 Support for COPD-X .. 12 Levels of evidence .. 13 Box 1: Levels of evidence .. 13 Key Recommendations of the COPD-X Guidelines .. 14 C: Case finding and confirm diagnosis .. 17 Figure 1: COPD Phenotypes .. 18 C1. Aetiology and natural history.