Quality Standard Details
Chronic Obstructive Pulmonary Disease (COPD): Care in the Community for Adults
- Publication Date
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2023-October-01
- Status
- Published
- Topic Area
- Lung Health
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Chronic obstructive pulmonary disease (COPD) is a progressive lung condition characterized by irreversible or partially reversible airflow obstruction. The main risk factors for COPD are current or past tobacco smoking, and exposure to toxic particles and gases originating from household and outdoor air pollution. Worldwide, COPD is a leading cause of morbidity and mortality. It results in social and economic burdens that are substantial and increasing. Although smoking rates are declining in Ontario, COPD is still one of the most common chronic conditions.
People with COPD also frequently require health care services. Before the COVID-19 pandemic, COPD was the second most common reason for hospitalization. Although COPD is a progressive illness, there are significant opportunities to improve the quality of life of people with the disease via the delivery of high-quality health care. Because most people with COPD are not diagnosed until the disease is well advanced, earlier identification and testing of symptomatic individuals at risk of developing COPD is an essential first step in managing this chronic condition.
This quality standard addresses care for people with COPD, including the assessment of people who may have COPD. It provides guidance on the diagnosis, management, and treatment of COPD in community-based settings. The scope of this quality standard applies to primary care, specialist care, home care, and long-term care.
Quality Standard in Brief
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Quality Statement 1: Diagnosis Confirmed With Spirometry
People clinically suspected of having COPD have spirometry testing to confirm diagnosis within 3 months of developing respiratory symptoms.
Quality Statement 2: Comprehensive Assessment
People with COPD have a comprehensive assessment to determine the degree of disability, risk of acute exacerbation, and presence of comorbidities near the time of diagnosis and on an annual basis. The severity of airflow limitation, as initially determined by spirometry testing to confirm diagnosis, is reassessed when people’s health status changes.
Quality Statement 3: Goals of Care and Individualized Care Planning
People with COPD discuss their goals of care with their future substitute decision-maker, their primary care provider, and other members of their interprofessional care team. These discussions inform individualized care planning, which is reviewed and updated regularly.
Quality Statement 4: Education and Self-Management
People with COPD and their caregivers receive verbal and written information about COPD from their health care professional and participate in interventions to support self-management, including the development of a written self-management plan.
Quality Statement 5: Promoting Smoking Cessation
People with COPD are asked about their tobacco-smoking status at every opportunity. Those who continue to smoke are offered pharmacological and nonpharmacological smoking cessation interventions.
Quality Statement 6: Pharmacological Management of Stable COPD
People with a confirmed diagnosis of COPD are offered individualized pharmacotherapy to improve symptoms and prevent acute exacerbations. Their medications are reviewed at least annually.
Quality Statement 7: Vaccinations
People with COPD are offered influenza, pneumococcal, and other vaccinations, as appropriate.
Quality Statement 8: Specialized Respiratory Care
People with a confirmed diagnosis of COPD are referred to specialized respiratory care when clinically indicated, after receiving a comprehensive assessment and being offered treatment in primary care. This consultation occurs in accordance with the urgency of their health status.
Quality Statement 9: Pulmonary Rehabilitation
People with moderate to severe, stable COPD are referred to a pulmonary rehabilitation program if they have activity or exercise limitations and breathlessness despite appropriate pharmacological management.
Quality Statement 10: Management of Acute Exacerbations of COPD
People with COPD have access to their primary care provider or a health care professional in their care team within 24 hours of the onset of an acute exacerbation.
Quality Statement 11: Follow-Up After Hospitalization for an Acute Exacerbation of COPD
People with COPD who have been hospitalized for an acute exacerbation have an in-person follow-up assessment within 7 days after discharge.
Quality Statement 12: Pulmonary Rehabilitation After Hospitalization for an Acute Exacerbation of COPD
People who have been admitted to hospital for an acute exacerbation of COPD are considered for pulmonary rehabilitation at the time of discharge. Those who are referred to a pulmonary rehabilitation program start the program within 1 month of hospital discharge.
Quality Statement 13: Palliative Care
People with COPD and their caregivers are offered palliative care support to meet their needs.
Quality Statement 14: Long-Term Oxygen Therapy
People with stable COPD who have clinical indications of hypoxemia receive an assessment for and, if needed, treatment with long-term oxygen therapy.
Supporting Documents
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Patient guide for this quality standard
Know what to ask for in your care
Placemat for this quality standard
A quick-reference resource for clinicians that summarizes the quality standard and includes links to helpful resources and tools
COPD quality standard implementation toolkit
Quality improvement tools and resources for health care professionals, including an action plan template
Supplementary information to support the data collection and measurement process
Additional Resources
If you would like to receive these resources, please send us a message using our contact form:
- Case for improvement (slide deck)
Share why this standard was created and the data behind it, to get the support you need to put it into practice - Technical specifications
See the technical specifications for the indicators within the quality standard - Information documents
- Using Race-Neutral Equations to Interpret Spirometry: Information for Clinicians
- Race-Neutral Measurement of Lung Function: Information for People Receiving Care
- Summary of the public feedback we received
- Case for improvement (slide deck)
Last Updated: February 24, 2026
