Differentiating COPD from Asthma in Clinical Practice

Asthma and chronic obstructive pulmonary disease (COPD) are interrelated diseases of airflow limitation. They share several common origins, symptoms, and treatments, but there are important differences that affect both diagnosis and recommended treatments. In fact, the most important reason for distinguishing COPD from asthma is the difference in treatment strategies. Although both asthma and COPD use the same types of treatments, the timing of their use in the disease course can have dramatic and important effects. Spirometry should be used to detect COPD in patients with symptoms. Many patients do not recognize their COPD symptoms so the primary care physician should be proactive in asking about symptoms. This article summarizes the key pathophysiologic, epidemiologic, and clinical differences and similarities between asthma and COPD, as well as recommended treatment strategies for both diseases and criteria for referring patients to a pulmonologist.