We develop resource and service management techniques to support spectrum users (SUs) with quality of service requirements in large-scale distributed dynamic spectrum access (DSA) systems. The proposed techniques empower SUs to seek and exploit spectrum opportunities dynamically and effectively, thereby maximizing the long-term service satisfaction levels that SUs receive from accessing and using the DSA system. Our techniques are efficient in terms of optimality, scalability, distributivity, and fairness. First, they enable SUs to achieve high service satisfaction levels by quickly locating and accessing available spectrum opportunities. Second, they are scalable by performing well in systems with small as well as large numbers of SUs. Third, they can be implemented in a decentralized manner by relying on local information only. Finally, they ensure fairness among SUs by allowing them to receive equal amounts of service.