Desktop Helper No. 10 - Rational use of inhaled medications for the patient with COPD and multiple comorbid conditions: Guidance for primary care

This 2-page Desktop Helper describes the challenges associated with the pharmacological management of the patient with COPD and multiple comorbid conditions, with a particular focus on the rational use of inhaled corticosteroids. It also provides guidance for the holistic care of such patients in the primary care setting.

It features the impact of comorbidities on treatment choices for patients with COPD, especially with regard to the risks and benefits of inhaled medications including long-acting beta-agonists (LABA) and long-acting muscarinic antagonists (LAMA), with a special focus on inhaled corticosteroids (ICS).


  • General action points to improve the management of multimorbid patient with COPD in the primary care setting 
  • Additional essential action points 
  • Treatment considerations for the multimorbid patient with COPD 

Authors: Ioanna Tsiligianni, Kristian Hoines, Christian Jensen, JanWillem WH Kocks, Bjorn Stallberg, Claudia Vicente, Rudi Peche 

Reviewers: Stewart Mercer, Luîs Andres Amorim Alves 

Editor: Tracey Lonergan 

Funding: Boehringer Ingelheim provided an unrestricted educational grant to support the development, typesetting, printing and associated costs but did not contribute to the content

Date published: December 2019

We invite members of our network to translate into additional languages.

A live discussion: COPD and multimorbidity.

Challenges of management of multimorbidity in different countries and settings from the primary care point of view, the collaboration with secondary care and gives practical advice on what to do.


  • Ioanna Tsiligianni from Greece. MD, PhD, MPH/HCM, General Practitioner, Assistant professor in the University of Crete, IPCRG Past President
  • Claudia Vicente from Portugal. MD, General practitioner, GRESP coordination member
  • Björn Ställberg from Sweeden. MD, GP, Associate Professor, Uppsala University, Sweden
  • Janwillem Kocks from Netherlands. IPCRG President, General Practitioner, Professor of Inhalation Medicine, OPRI, Singapore Director GPRI
  • Kristian Jong Hoeines from Norway. GP, Chair Norwegian branch of IPCRG
  • Rudi Peche from Belgium. MD, FCCP, Pulmonologist, Head of pneumology department ,CHU Charleroi, Past President of the Belgian Respiratory Society