Han Sang Min, Kim Hyo Seon, Park Seung Yong, Lee Heung Bum, Park Young Bum, Rhee Chin Kook, Kim Youlim, Park Seoung Ju
Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Jeonbuk National University Medical School, Jeonju, Republic of Korea.
Division of Pulmonary, Allergy and Critical Care Medicine, Kangdong Sacred Heart Hospital, Hallym University Medical Center, Seoul, Republic of Korea.
Tuberc Respir Dis (Seoul). 2025 Apr;88(2):310-321. doi: 10.4046/trd.2024.0130. Epub 2025 Feb 6.
This study evaluated adherence to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) and Korean guidelines in the prescription patterns of respiratory specialists for stable chronic obstructive pulmonary disease (COPD) management.
Data were collected on medications from 2011 to 2022 using the Korea COPD Subtype Study (KOCOSS) cohort. Patients were divided into two groups: those registered before and after 2019, and we analyzed the percentage of patients meeting the recommended treatment criteria established by each guideline.
Among 3,477 patients, 85.6% received pharmacological therapy, and 81.6% utilized inhaled medications. Compared to patients enrolled before 2019, there was an increase in inhaler prescriptions among those registered after 2019 (79.7% vs. 86.7%), with dual bronchodilators being the predominant therapy prescribed. Of the patients receiving treatment, 56.9% adhered to the Korean 2018 guideline. Compliance with the GOLD 2019 and GOLD 2023 guidelines was observed in 31.3% and 28.0% of cases, respectively. When analyzing inhaler prescription patterns according to both subgroups and considering the Korean 2018, GOLD 2019, and GOLD 2023 guidelines concurrently, the adherence rates were as follows: (56.6%, 37.8%, 24.0%) and (57.7%, 14.0%, 38.6%).
Adherence rates were higher for the Korean guideline compared to the GOLD recommendations. Furthermore, alignment with both the Korean 2018 and GOLD 2023 guidelines increased among patients enrolled after 2019, compared to those registered earlier. These findings suggest that physicians are modifying their therapeutic strategies to align with both domestic and recent international guidelines.
本研究评估了呼吸专科医生在稳定期慢性阻塞性肺疾病（COPD）管理的处方模式中对慢性阻塞性肺疾病全球倡议（GOLD）和韩国指南的遵循情况。
使用韩国慢性阻塞性肺疾病亚型研究（KOCOSS）队列收集2011年至2022年的药物数据。患者分为两组：2019年之前和之后登记的患者，我们分析了符合各指南制定的推荐治疗标准的患者百分比。
在3477名患者中，85.6%接受了药物治疗，81.6%使用了吸入药物。与2019年之前登记的患者相比，2019年之后登记的患者吸入器处方有所增加（79.7%对86.7%），双重支气管扩张剂是主要的处方治疗方法。在接受治疗的患者中，56.9%遵循了韩国2018年指南。分别有31.3%和28.0%的病例符合GOLD 2019和GOLD 2023指南。根据两个亚组分析吸入器处方模式并同时考虑韩国2018年、GOLD 2019年和GOLD 2023年指南时，遵循率如下：（56.6%，37.8%，24.0%）和（57.7%，14.0%，38.6%）。
与GOLD建议相比，韩国指南的遵循率更高。此外，与2019年之后登记的患者相比，2019年之前登记的患者中符合韩国2018年和GOLD 2023年指南的情况有所增加。这些发现表明医生正在调整他们的治疗策略以符合国内和最新的国际指南。
