By rray, 7 April, 2023 Exclude Patient Type Detail Header No Detail Type Text Detail Text If smoker cessation tx A using 1 first line tx nicotine gum lozenge inhaler spray patch or meds bupropion nortriptyline use drugs along w intervention program counsel3 at every visit Efficacy of e cig as cessation aid controversial Vaccinate COVID 19 according to nat l recs B Flu annually A Tdap if not previously received B Zoster if 50 yo B CDC recommends 1 dose of PCV20 or 1 dose of PCV15 followed by PPSV23 in pts w COPD B If environment risks Efficient ventilation nonpolluting cooking stoves etc B avoidance of irritants if possible D Create written COPD exac action plan w educational component maintain regular clinician contact Encourage physical activity ensure adequate sleep healthy diet Check spirometry q1y4 Eval and treat comorbidities CV etc5 Consider shielding measures eg masking social distancing handwashing to prevent exac in winter months Follow COVID 19 mitigation strategies6 and test for SARS CoV 2 if warranted eg new or worsening resp sx fever loss of taste and or smell 7 Patient Type Detail Header (Long) Mitigate risks