The adherence to and utility of the Global Initiative for Chronic Obstructive Lung Disease guidelines for treating COPD among pulmonary specialists: a retrospective analysis

BMC Pulmonary Medicine

Research

Pierina S. Benel Barletti¹  Kayla M. DeBarros¹  Randall K. James¹  Jica Garces¹  Fortune O. Alabi¹  Kayla Garcia¹  Hadaya A. Alkhateeb²  Mukudzeishe T. Zibanayi³ 

[1] Florida Lung Asthma and Sleep Specialists, Kissimmee, FL, USA;Philadelphia College of Osteopathic Medicine, Suwanee, GA, USA;Ross University School of Medicine, Bridgetown, Barbados;

关键词: COPD assessment test;    Global Initiative for Chronic Obstructive Lung Disease;    COPD classification;    ICS;    Triple therapy;    Guideline adherence;    CAT score;   

DOI  :  10.1186/s12890-023-02503-7

 received in 2023-02-21, accepted in 2023-05-31,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundDespite the evidence-based guidelines promoted by the Global Initiative for Chronic Obstructive Lung Disease (GOLD), the overuse of prescription drugs to manage COPD, particularly inhaled corticosteroids (ICS), remains a persistent challenge. In this real-world study, we evaluated how patients with COPD were divided into ABCD groups based on the 2017 GOLD guidelines, determined the rate of adherence to the GOLD treatment recommendations, described the rate of ICS usage, and determined the rate of triple therapy (TT) prescription.MethodsThe charts of 2291 patients diagnosed with COPD were retrospectively analyzed, of which 1438 matched the eligibility criteria.ResultsThe average patient age was 69.6 ± 10.9 years; 52% of patients were female. The average COPD assessment test (CAT) score was 18.3 ± 9.1. The ABCD breakdown was as follows: group A 19.5%, group B 64.1%, group C 1.8%, and group D 14.6%. All groups, except group D, showed discordance in COPD treatment relative to the proposed GOLD guidelines. Only 18.9% of group A and 26% of group B were treated in concordance with the guidelines. TT was primarily used in group D (63.3%) and overused in groups A (30.6%) and B (47.8%). ICS was overused in all groups, particularly in groups A (56.2%) and B (67.3%).ConclusionStudies from the last decade have consistently revealed a lack of conformity between what physicians prescribe and what GOLD guidelines recommend. The excessive usage of ICS, which continues despite all the associated adverse effects and the attributable costs, is concerning. The awareness of GOLD guidelines among primary care physicians (PCPs) and respiratory specialists needs to be improved.

【 授权许可】

CC BY   
© The Author(s) 2023

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