Similarity and difference in COPD evaluation and medicine suggestion in GOLD 2011 an d GOLD 2006 documents and pulmonologist's compliance
10.3760/cma.j.issn.1008-1372.2015.03.004
- VernacularTitle:GOLD 2011与 GOLD 2006文件在 COPD 病情评估和药物推荐异同及医生依从性分析
- Author:
Dan LIU
;
Zijing ZHOU
;
Ping CHEN
- Publication Type:Journal Article
- Keywords:
Pulmonary disease,chronic obstructive/DI/DT;
Patient compliance
- From:
Journal of Chinese Physician
2015;(3):331-336
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the similarity and difference in chronic obstructive pulmonary disease ( COPD) evaluation and drug selection that were compared between global initiative for chronic ob-structive lung disease (GOLD) 2011 and GOLD 2006, and to explore treatment adherence by doctors ac-cording to GOLD 2011.M ethods We collected 224 patients with COPD from Department of Respiratory Medicine at the Second Xiangya Hospital to investigate the differences in COPD evaluation and drug selec-tion according to GOLD 2011 and GOLD 2006 with treatment adherence by doctors according to GOLD 2011.Results ⑴According to GOLD 2006, there were 38 patients in the most severe stage, which was different from that (Group D, 147) according to GOLD 2011 ( P <0.01).⑵The risk stratification by u-sing pulmonary function assessment was significantly different from that by using exacerbation history.⑶Symptom assessment by using COPD assessment test ( CAT) was significantly different from that by using modified British medical research council ( mMRC) .The kappa coefficient of these two questionnaires was 0.466, suggesting moderate agreement.⑷ According to GOLD 2011, 224 (100%) patients were recom-mended to use inhaled long-acting bronchodilators, which was higher than that (213, 95.18%) according to GOLD2006 ( P <0.01).⑸The level of appropriated actual prescription was 161 (71.9%) according to GOLD 2011, which was significantly different from that (120,53.1%) according to GOLD 2006 ( P <0.01).Conclusions ⑴ Compared to GOLD 2006, GOLD 2011 categorized more patients into the most severe group.⑵The risk stratification of COPD by airflow limitation severity or exacerbation risk was not i-dentical.Discordance between CAT and mMRC was observed.⑶GOLD 2011 recommends a wider range of using long-acting bronchodilators.⑷The adherence to GOLD guideline in our hospital is still far from satis-faction.
