Nowak Marcin, Brożek Grzegorz M, Zejda Jan E, Jankowski Mateusz, Pierzchała Władysław
ADAMED Group, Czosnow, Poland.
Department of Epidemiology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland.
Postepy Dermatol Alergol. 2020 Apr;37(2):221-228. doi: 10.5114/ada.2018.79143. Epub 2018 Nov 14.
The international standard for the recognition and treatment of chronic obstructive pulmonary disease (COPD) is guided by a regularly updated set of criteria developed by the Global Initiative for Chronic Obstructive Lung Disease (GOLD).
To investigate the impact of updated COPD management guidelines from 2007 to 2017 (GOLD 2007, GOLD 2011 and GOLD 2017) on the assignment of patients into individual therapeutic groups, examining both individual and population dimensions.
Each of 500 randomly chosen primary care physicians in Poland provided information on 10 individual COPD patients (disease history, clinical status, treatment and pharmacotherapy). This data was used to simulate the consequences of the implementation of the GOLD 2007, 2011 and 2017 guidelines.
A group of 298 physicians of 500 approached provided information on 2597 patients (64.2% males) aged 29-96 (61.6 ±11.1 years). Based on GOLD 2007 guidelines, most patients (56.7%) presented a severe stage of COPD. GOLD 2011 updates would significantly increase the proportion of patients with the most severe stage of disease, and this group would be predominantly classified as moderate or severe in GOLD 2007. The implementation of GOLD 2017 guidelines would result in a significant migration of patients towards the lightest (category A) form of the disease.
Updates to the GOLD 2007 COPD guidelines for GOLD 2011 and 2017 would have a significant impact on the classification of patients for particular therapeutic groups. As a result of the migration of patients to particular therapeutic groups, the pharmacological treatment would also change.
慢性阻塞性肺疾病（COPD）的国际诊断与治疗标准是由慢性阻塞性肺疾病全球倡议组织（GOLD）定期更新的一系列标准所指导。
研究2007年至2017年慢性阻塞性肺疾病管理指南（GOLD 2007、GOLD 2011和GOLD 2017）对患者分组至不同治疗组别的影响，同时考察个体和总体层面。
在波兰随机选取500名初级保健医生，每位医生提供10例慢性阻塞性肺疾病患者的信息（病史、临床状况、治疗及药物治疗情况）。这些数据用于模拟实施GOLD 2007、2011和2017指南的后果。
500名受访医生中有298名医生提供了2597例患者（64.2%为男性）的信息，患者年龄在29 - 96岁之间（61.6±11.1岁）。根据GOLD 2007指南，大多数患者（56.7%）处于慢性阻塞性肺疾病重度阶段。GOLD 2011的更新将显著增加疾病最严重阶段患者的比例，而在GOLD 2007中，这组患者主要被归类为中度或重度。实施GOLD 2017指南将导致患者显著向疾病最轻（A类）形式转移。
从GOLD 2007到GOLD 2011和2017的慢性阻塞性肺疾病指南更新将对特定治疗组患者的分类产生重大影响。由于患者向特定治疗组的转移，药物治疗也会发生变化。
