5th May 2024

A 62-year-old male with a history of COPD presents with worsening breathlessness and reduced exercise tolerance over the past few months.

A 62-year-old male with a history of COPD presents with worsening breathlessness and reduced exercise tolerance over the past few months. He is a current smoker with a 40 pack-year history. He has been using salbutamol (a SABA) as needed, which now seems less effective. He reports two exacerbations in the last year, neither requiring hospitalisation. His current COPD Assessment Test (CAT) score is 13.

Which of the following is the most appropriate management step for his COPD?