ACE Clinical Guidances (ACGs)

[also known as Appropriate Care Guides]

ACGs provide concise, evidence-based recommendations to inform specific areas of clinical practice and serve as a common starting point nationally for clinical decision-making. ACGs are underpinned by a wide array of considerations contextualised to Singapore, based on best available evidence at the time of development. Each ACG is developed in collaboration with a multidisciplinary group of local experts representing relevant specialties and practice settings. ACGs are not exhaustive of the subject matter and do not replace clinical judgement.

Published on 25 Sep 2018
Last Updated on 25 Sep 2018
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This Appropriate Care Guide (ACG) outlines the overall recommendations to managing stable COPD. With a particular focus on inhalers, it highlights the stepwise approach to selecting appropriate inhalers.

Download the PDF below to access the full ACG.

Key Messages
1. Check smoking status and offer smoking cessation counselling at every opportunity.
2. Use LAMA when response to short-acting bronchodilators is inadequate.
3. Offer LAMA+LABA in patients with persistent symptoms and exacerbations.
4. Use ICS with LAMA+LABA only when there are further exacerbations despite LAMA+LABA therapy.
5. Switch patients on ICS without exacerbations in the past year to LAMA or LAMA+LABA.


Managing stable COPD - focusing on inhalers (Sep 2018)