A 62-year-old male smoker with a 40 pack-year history presents with progressive dyspnea, chronic productive cough, and recurrent respiratory infections over the past 3 years. Spirometry shows FEV₁/FVC ratio of 0.58 with FEV₁ 45% predicted. Chest X-ray reveals hyperinflation and bronchial wall thickening. He is currently on inhaled long-acting beta-2 agonist monotherapy. What is the most appropriate next step in management?

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