**7. Prevention**

Preventing exacerbations is an important treatment goal in COPD. There is a wide range of preventive measures which have proven to reduce exacerbation frequency or hospitalization in patients with AECOPD.

#### **7.1. Supportive measures**

Influenza vaccination and pneumococcal vaccination have both been researched as preventive measures for infection associated exacerbations. Current GOLD guidelines [8] advise influenza vaccination for patients with COPD. Pneumococcal vaccination is mainly advised for elderly patients with COPD. Investigation on this subject is ongoing. Of the non-pharmacologic interventions, pulmonary rehabilitation is the most effective in reducing hospital admissions and mortality and improving health-related quality of life in COPD patients who have recently suffered an exacerbation of COPD [74].
