Appropriate prescribing for any condition depends
on the correct diagnosis being made in the first place.
There is currently a strong focus on the importance of
accurate spirometry technique and interpretation, as
the quality of spirometry being performed has been
questioned (NHS Improvement, 2008). However, it is
also important to remember that the diagnosis largely
depends on an accurate history being taken, with
spirometry used to confirm the diagnosis. A history of
a gradual onset of breathlessness, cough, sputum, and
recurrent chest infections—particularly in a patient
with risk factors for COPD, such as a significant
smoking history—should alert a health professional to
the possibility of COPD as a diagnosis. Spirometry can
then be performed and interpreted by an appropriately
trained individual to confirm the presence of airflow
limitation without significant reversibility, as would
usually be seen in COPD (World Health Organization
(WHO), 2012).