O1.3 Assessment of response and continuation of bronchodilator therapy

In some patients a response to bronchodilator therapy may require treatment for up to two months. Symptomatic and functional benefits can often be demon­strated in the absence of an increase in FEV₁. Other objective measurements, such as an increase in exercise capacity (e.g., six-minute walk distance) or an increased inspiratory reserve capacity, may be useful indicators of physiological improvement.

Subjective measurements, such as quality of life, breath­lessness and functional limitation (e.g., MRC Dyspnoea Scale), can determine the patient’s perception of benefit.

If there is no improvement:

• check inhaler technique;
• consider psychosocial issues and deconditioning; and
• exclude other causes of exercise impairment (consider specialist referral or a cardiopulmonary exercise test).