The importance of regular exercise and an interactive way to help people with COPD use their inhalers correctly are just some of the new additions to the updated stepwise guidelines.

Spokesman for Lung Foundation Australia Professor Ian Yang told the limbic the latest updates to the Stepwise reference guide were subtle but important.

“It now includes a recommendation to encourage regular exercise to optimise function,” he said.

“We have moved cardiovascular disease to the top of the comorbidity list to reflect its prevalence and importance, and have brought forward consideration of oxygen therapy, surgery, bronchoscopic interventions, palliative care services and advanced care planning from severe to moderate disease.”

A previous recommendation to consider low dose theophylline has been removed due to the relatively weak evidence for its use.

Professor Yang said the Stepwise guide also incorporated an interactive educational feature – using the Blippar mobile app to link to video explanations of correct inhaler technique.

Given evidence up to 90% of patients don’t use their inhaler devices correctly, technique and adherence should be checked at each visit.