Sen Elif, Guclu Salih Zeki, Kibar Isil, Ocal Ulku, Yilmaz Veysel, Celik Onur, Cimen Filiz, Topcu Fusun, Orhun Meltem, Tereci Hikmet, Konya Aylin, Ar Idilhan, Saryal Sevgi
Department of Pulmonary Diseases, Ankara University School of Medicine, Ankara, Turkey.
Pulmonary Diseases Department, Izmir Dr Suat Seren Surgery Training and Research Hospital, Izmir, Turkey.
Int J Chron Obstruct Pulmon Dis. 2015 Dec 10;10:2657-63. doi: 10.2147/COPD.S85324. eCollection 2015.
Low adherence to Global initiative for chronic Obstructive Lung Disease (GOLD) guideline recommendations has been reported worldwide. There has been no study on the adherence to GOLD guidelines for COPD treatment in Turkey.
To investigate the rates of adherence to GOLD 2010 guidelines for COPD treatment among pulmonologists.
A multi-center, cross-sectional, observational study was carried out in eleven pulmonary outpatient clinics across Turkey. Adherence to GOLD was evaluated through hospital records. Demographic and clinical data were recorded.
Study included 719 patients (mean age: 62.9±9.7 years; males 85.4%) of whom 16 was classified as GOLD Stage I, 238 as II, 346 as III, and 119 as IV, and only 59.5% received appropriate treatment. Rates of guideline adherence varied across GOLD stages (I, 6.3%; II, 14.7%; III, 84.4%; and IV, 84%). Causes of inappropriate therapies were overtreatment (Stage I, 100% and Stage II, 91.1%), undertreatment (Stage III, 3.3% and Stage IV, 10.9%) and lack of treatment (Stage II, 3.8%; Stage III, 2.3%; and Stage IV, 5.9%). The most preferred regimen (43.4%) was long-acting β2-agonist-inhaled corticosteroid-long-acting muscarinic antagonist. Overall, 614 patients (89%) received treatment containing inhaled corticosteroid.
Pulmonologists in Turkey have low rates of adherence to GOLD guidelines in COPD treatment. Inappropriateness of therapies was due to overtreatment in early stages and excessive use of inhaled corticosteroid (ICS) in all disease stages.
全球慢性阻塞性肺疾病倡议（GOLD）指南建议的依从性在全球范围内都有报道。土耳其尚未有关于慢性阻塞性肺疾病（COPD）治疗中GOLD指南依从性的研究。
调查土耳其呼吸科医生对GOLD 2010 COPD治疗指南的依从率。
在土耳其的11家肺部门诊进行了一项多中心、横断面观察性研究。通过医院记录评估对GOLD的依从性。记录人口统计学和临床数据。
研究纳入719例患者（平均年龄：62.9±9.7岁；男性占85.4%），其中16例被分类为GOLD I期，238例为II期，346例为III期，119例为IV期，只有59.5%的患者接受了适当治疗。指南依从率在不同GOLD阶段有所不同（I期，6.3%；II期，14.7%；III期，84.4%；IV期，84%）。不适当治疗的原因包括过度治疗（I期，100%；II期，91.1%）、治疗不足（III期，3.3%；IV期，10.9%）和未治疗（II期，3.8%；III期，2.3%；IV期，5.9%）。最常用的治疗方案（43.4%）是长效β2受体激动剂-吸入性糖皮质激素-长效毒蕈碱拮抗剂。总体而言，614例患者（89%）接受了含吸入性糖皮质激素的治疗。
土耳其呼吸科医生在COPD治疗中对GOLD指南的依从率较低。治疗不当是由于早期过度治疗以及在所有疾病阶段吸入性糖皮质激素（ICS）的过度使用。
