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Instructions for COPD MANAGEMENT PLAN

What is a COPD Management Plan, and how do you use it?
A management plan is a personal tool that helps you talk with your health care provider about your COPD. With a
management plan, you will know how and when to take your medicines, when to call your health care provider, and when
to get emergency care. A management plan also helps you track how you are doing, any concerns you may have, and any
changes in your health that are important to discuss with your doctor.
Each person’s COPD is different and so is each management plan. We hope that you will use the tools provided here to
work with your doctor to make a plan that is right for you.

There are three parts to a good management plan.
The COPD MANAGEMENT PLAN and COPD ACTION PLAN should be filled out with your health care provider during
your physicians visit. You should bring these with you every time you visit your doctor.
The first part outlined in BLUE is called MY COPD MANAGEMENT PLAN. It is your record of general contact
information, lung function measurements, and lung health care plan. This section is also used to record your current
medications, including oxygen settings if you are using supplemental oxygen, and other health conditions. It also helps
you and your health care provider identify all of your different treatment options.
The second part in Green, Yellow and Red (like a traffic light) is called MY COPD ACTION PLAN. This is used to help
you know what to do when your symptoms worsen. This plan is to be completed by you, with the help of your health care
provider, and should be reviewed and updated at every visit. The plan includes a comprehensive list of symptoms, but
you may experience other symptoms. If you are unclear as to the actions you should take, please contact your physician/
health care provider immediately. When listing your symptoms, the Green zone is when you are doing well, the Yellow
zone is for when you are having a bad day, and the Red zone is for when you need urgent medical care. In each zone
there is a list of symptoms and the appropriate actions you should take if you are in that zone.
The third part to a good management plan is called MY COPD REPORT CARD and it is outlined in BLUE. This is a
tracking report of how you have been feeling and should be used to help facilitate the discussion with your health care
provider. The COPD REPORT CARD should be filled out before every doctor visit. Be sure to take it with you! If you are
seeing your doctor for a routine visit, fill out the report describing how you have been feeling since your last visit. If you
are seeing your doctor for urgent care or a “flare up” of your symptoms, fill out the report describing how you feel right
at that time. The Report Card also includes your general contact information and listing of your current medications. It
also has a list of detailed COPD symptoms and other health concerns you may be experiencing and want to discuss with
your physician.

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For more information or to download additional copies
of the COPD Action Plan, please visit www.lungusa.org
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