Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2020 Mar;26(2):149-154.
doi: 10.1097/MCP.0000000000000655.

Adherence to Global Initiative for Chronic Obstructive Lung Disease guidelines in the real world: current understanding, barriers, and solutions

Hasan Ahmad Hasan Albitar  1 , Vivek N Iyer  2
Affiliations
Review

Adherence to Global Initiative for Chronic Obstructive Lung Disease guidelines in the real world: current understanding, barriers, and solutions

Hasan Ahmad Hasan Albitar et al. Curr Opin Pulm Med. 2020 Mar.

Abstract

Purpose of review: The Global Initiative for Chronic Obstructive Lung Disease (GOLD) provides a comprehensive review and guidance for clinicians managing patients with chronic obstructive pulmonary disease (COPD). However, adherence to GOLD guidelines has been suboptimal over the years. The current review summarizes the current body of literature addressing the multitude of reasons for the lack of adherence to GOLD guidelines in clinical practice.

Recent findings: There continue to be several reasons for suboptimal adoption of GOLD guidelines in clinical practice. A primary and recurrent theme appears to be both delayed as well as missed diagnosis of COPD. There are several reasons for this including lack of awareness about current COPD guidelines, lack of availability as well as utilization of office spirometry and improper symptom assessment. Other issues include improper selection of proper pharmacotherapy options, misdiagnosis/mislabeling of COPD phenotypes, lack of smoking cessation counselling as well as enrollment in pulmonary rehabilitation. Potential solutions include adoption of clinical decision support systems, self-care models and careful phenotyping of COPD patients.

Summary: There are currently several barriers for the adoption of GOLD guidelines into routine clinical practice. These barriers are all amenable to systematic solutions that will increase adherence to current GOLD guidelines.

PubMed Disclaimer

References

    1. Mirza S, Clay RD, Koslow MA, Scanlon PD. COPD guidelines: a review of the 2018 GOLD report. Mayo Clin Proc 2018; 93:1488–1502.
    1. Rennard SI, Vestbo J. COPD: the dangerous underestimate of 15%. Lancet 2006; 367:1216–1219.
    1. Lokke A, Lange P, Scharling H, et al. Developing COPD: a 25 year follow up study of the general population. Thorax 2006; 61 (11):935–939.
    1. Ashley F, Kannel WB, Sorlie PD, Masson R. Pulmonary function: relation to aging, cigarette habit, and mortality. Ann Intern Med 1975; 82:739–745.
    1. Lange P, Nyboe J, Jensen G, et al. Ventilatory function impairment and risk of cardiovascular death and of fatal or nonfatal myocardial infarction. Eur Respir J 1991; 4:1080–1087.

MeSH terms