A 72-year-old female with severe COPD is experiencing an increased frequency of exacerbations. She is on triple therapy with a LAMA, LABA, and inhaled corticosteroids. What are potential further management strategies?
For a patient with severe COPD experiencing frequent exacerbations despite triple therapy, options include checking the inhaler technique and adherence, considering pulmonary rehabilitation, evaluating for long-term oxygen therapy if hypoxemic, and considering roflumilast or azithromycin if she has chronic bronchitis. She should also be evaluated for comorbid conditions that could be worsening her COPD, such as heart failure, ischemic heart disease, or obstructive sleep apnea.