Patients often bypass Primary Care services and go to A&E due to a lack of self management advice and empowerment. COPD patients typically experience their symptoms for on average 7 days before an emergency attendance at A&E.

In an exacerbation, the earlier recognition and treatment is started the better. Patients should be taught how to recognise an exacerbation and how to implement appropriate management strategies, including a rescue pack of antibiotics and/or oral steroids for self-treatment at home where indicated. They should also be warned to seek help if their self-management is not working. Patients should be asked to notify their GP or nurse when they have been used so that the exacerbation can be recorded and rescue pack supply replenished.