Differentiating chronic obstructive pulmonary disease from asthma

J Am Acad Nurse Pract. 2008 Sep;20(9):445-54. doi: 10.1111/j.1745-7599.2008.00332.x.


Purpose: Chronic obstructive pulmonary disease (COPD) and asthma are chronic diseases that are increasing worldwide in incidence, prevalence, and burden. The purpose of this article is to provide nurse practitioners (NPs) with the information necessary to make a differential diagnosis and to understand the different treatment approaches to these two diseases.

Data sources: Peer-reviewed journal articles, book chapters, and evidence-based Internet sources.

Conclusions: NPs who are familiar with the pathophysiology that differentiates COPD from asthma can make an appropriate diagnosis and initiate effective pharmacologic and nonpharmacologic interventions, which may lead to a reduced incidence of exacerbations.

Implications for practice: A misdiagnosis of COPD or asthma leads to inadequate management of patients and to escalating healthcare costs. An early and accurate diagnosis can help to ensure optimal and cost-effective management of patient care.

Publication types

  • Review

MeSH terms

  • Adrenergic beta-Agonists / therapeutic use
  • Anti-Inflammatory Agents / therapeutic use
  • Asthma / diagnosis*
  • Asthma / drug therapy*
  • Asthma / epidemiology
  • Bronchodilator Agents / therapeutic use
  • Causality
  • Cholinergic Antagonists / therapeutic use
  • Diagnosis, Differential
  • Forced Expiratory Volume
  • Humans
  • Leukotriene Antagonists / therapeutic use
  • Medical History Taking
  • Nurse Practitioners / organization & administration*
  • Nurse's Role
  • Nursing Assessment / organization & administration*
  • Peak Expiratory Flow Rate
  • Physical Examination
  • Pulmonary Disease, Chronic Obstructive / diagnosis*
  • Pulmonary Disease, Chronic Obstructive / drug therapy*
  • Pulmonary Disease, Chronic Obstructive / epidemiology
  • Severity of Illness Index
  • Spirometry
  • Theophylline / therapeutic use
  • United States / epidemiology


  • Adrenergic beta-Agonists
  • Anti-Inflammatory Agents
  • Bronchodilator Agents
  • Cholinergic Antagonists
  • Leukotriene Antagonists
  • Theophylline