The report also includes changes in treatment strategy. New options for treatment include a contemporary set of escalation strategies for patients still having persistent symptoms or exacerbations. Studies have been done to compare and contrast the new guidelines' effectiveness [ 13 - 15 ].
One objective has been to predict which patients will have exacerbations in the following year and compare that to previous guideline predictions [ 13 ]. It has been determined that there is a consistency in its ability to predict exacerbations in both current and previous guidelines [ 13 ]. Despite this, there is still a great deal of uncertainty regarding the new guidelines' impact on patient mortality and morbidity.
More studies need to be done. The guidelines no longer recommend spirometry as the sole diagnostic test for COPD diagnosis because even with its good sensitivity, it has a weak specificity.
Therefore, symptom assessment and exacerbation history have changed how patients are diagnosed. Although there is inadequate data, it is perceived that a reclassification has been executed, all the potential variables have not been identified, and it is still unclear about whether patients are directly benefiting from the changed treatment according to their new classification. COPD is still a leading cause of mortality in the world and is greatly under-diagnosed and inappropriately treated.
More studies are required, and as physicians it becomes important for us to understand the current stance on COPD classification and treatment. By learning this, we can address the deficiencies of the current classification and aid in its improvement.
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Published online Jun Author information Article notes Copyright and License information Disclaimer. Corresponding author. Avani R. Patel moc. Received Jun 3; Accepted Jun This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
This article has been cited by other articles in PMC. Abstract Chronic obstructive pulmonary disease or COPD is one of the conditions that physicians frequently see in both the hospital and outpatient setting. Keywords: spirometry, smoking, abcd assessment tool, long-acting beta-2 agonist, global initiative for chronic obstructive lung disease, chronic obstructive pulmonary disease copd , persistent airflow limitation, forced vital capacity, forced expiratory volume in one second, copd exacerbation.
Introduction and background Chronic obstructive pulmonary disease COPD has become a major concern for global health. Open in a separate window. Figure 1. COPD: chronic obstructive pulmonary disease. Review Assessment of a COPD patient For physicians, the goals of COPD assessment are to determine the disease severity, the degree of airflow limitation, and the decompensation risk [ 2 ]. Figure 2. Footnotes The authors have declared that no competing interests exist.
References 1. COPD: definition and phenotypes. Skip to main content Thank you for visiting nature. Download PDF. You have full access to this article via your institution. View author publications. Rights and permissions Reprints and Permissions. About this article Cite this article Gruffydd-Jones, K. Copy to clipboard. Bloom Jukka Montonen Surya P. About the journal Journal Information.
Publish with us Submit manuscript. Search Search articles by subject, keyword or author. Show results from All journals This journal. Primary Care Respiratory Society. Diagnosis and management of COPD in primary care. Download references. You can also search for this author in PubMed Google Scholar. Correspondence to Kevin Gruffydd-Jones. Reprints and Permissions. Gruffydd-Jones, K. GOLD guidelines what are the implications for primary care?.
Prim Care Respir J 21, — Download citation. Received : 02 January Revised : 11 April Accepted : 15 April Published : 11 July Issue Date : December Anyone you share the following link with will be able to read this content:. Sorry, a shareable link is not currently available for this article. Provided by the Springer Nature SharedIt content-sharing initiative. Advanced search. Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.
Skip to main content Thank you for visiting nature. GOLD guidelines what are the implications for primary care? Download PDF. Abstract A major revision of the Global Initiative for Chronic Obstructive Lung Disease GOLD guidelines was published in December , which takes account of the fact that chronic obstructive pulmonary disease COPD is a multi-system disease with effects on the patient beyond the effects of airflow limitation alone.
You have full access to this article via your institution. This article discusses these changes and the implications for primary care. Figure 1. Full size image. Pharmacological therapy Figure 2.
Figure 3. A proposal for defining the goal of COPD management. Co-morbidities There is a new chapter in the guidelines reflecting the importance and treatment of co-morbidities in improving current control and reducing future risk. Some of the challenges for primary care in implementing these guidelines are: 1 The pivotal role of spirometry in the diagnosis of COPD provides a major challenge to primary care in developed countries where the quality of spirometry is variable 3 and in developing countries where there is limited access to relatively expensive diagnostic equipment.
Acknowledgements Funding None. Handling editor Hilary Pinnock. Rights and permissions Reprints and Permissions. About this article Cite this article Gruffydd-Jones, K. Copy to clipboard.
About the journal Journal Information.
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