Objective To explore the intervention effect of 5A management program implemented in respiratory specialist nursing clinic on outpatients with chronic obstructive pulmonary disease (COPD).Methods A randomized controlled study was conducted. A total of 106 COPD outpatients who attended the respiratory specialist nursing clinic from April to December 2024 were enrolled and randomly divided into an experimental group and a control group, with 53 cases in each group. The control group received routine health management, while the experimental group was subjected to the 5A management program for COPD in the respiratory specialist nursing clinic. After 3 months of intervention, the degree of dyspnea, quality of life, mastery of inhalation technique, medication compliance and hospitalization rate due to acute exacerbation were compared between the two groups. Results A total of 48 cases in the control group and 50 cases in the experimental group completed the study. The scores of dyspnea severity between the two groups showed significant differences in time effect and interaction effect,the scores of quality of life, inhalation technique and medication adherence exhibited significant differences in between-group effect, time effect and interaction effect，and the quality of life, correct use of inhalation devices，medication adherence to inhalers showed statistically significant differences across group effects, time effects, and interaction effects (P<0.05 for all). Within the first 3 months of intervention, the hospitalization rate had no statistically significant difference between the two groups (P>0.05). Conclusion The implementation of the 5A management protocol in respiratory specialty outpatient clinics is conducive to improving the quality of life, mastery of inhalation techniques, and medication adherence among COPD patients, while its effects on alleviating dyspnea and reducing the hospitalization rate due to acute exacerbations warrant further investigation.