Economic Impact of Low Adherence to COPD Management Guidelines in Spain

Miravitlles, Marc; Solé, Alexandra; Aguilar, Helena; Ampudia, Ana; Costa-Samarra, J.; Mallén-Alberdi, Maria; Nieves, Diana

doi:10.2147/copd.s322793

Cited by 5 publications

(10 citation statements)

References 41 publications

(88 reference statements)

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“…19 Despite there is a debate on the best choice of antibiotic class, the use of antibiotics has been a major point in management of COPD patients in many guidelines of COPD management other than GOLD strategy document. 15,16 We found less than 100% adherence in other parameters for COPD exacerbation treatment. These include the use of spirometry, controlled oxygen, methyl xanthine usage, non-invasive ventilation (NIV), and invasive mechanical ventilation (IMV).…”

Section: Discussionmentioning

confidence: 80%

“…Use of Arterial Blood Gases in patients is a good tool for early detection and estimating prognosis of severe disease as proved by many other studies 14 Similarly use of chest x-ray in acute exacerbation of COPD is necessary to detect causes of acute exacerbation of COPD like pneumonia, Pneumothorax and Pulmonary edema. 15 Our study shows all patients had chest x-rays and arterial blood gases (ABGs) which is also advocated in other guidelines especially NICE COPD guidelines. 15,16 Similarly, the use of short-acting betaagonist (SABA), intravenous corticosteroids, and antibiotics were used in all patients with COPD exacerbation treatment.…”

Section: Discussionmentioning

confidence: 93%

“…15 Our study shows all patients had chest x-rays and arterial blood gases (ABGs) which is also advocated in other guidelines especially NICE COPD guidelines. 15,16 Similarly, the use of short-acting betaagonist (SABA), intravenous corticosteroids, and antibiotics were used in all patients with COPD exacerbation treatment. GOLD strategy document includes use of Short acting beta-agonists or use of short acting muscarinic antagonists.…”

Section: Discussionmentioning

confidence: 93%

“…Systemic steroids have been mainstay of COPD exacerbation management in all guidelines. 15,16 however many studies show that inhaled corticosteroids may prove beneficial in COPD exacerbation management as depicted by a clinical review published in India. 19 Despite there is a debate on the best choice of antibiotic class, the use of antibiotics has been a major point in management of COPD patients in many guidelines of COPD management other than GOLD strategy document.…”

Section: Discussionmentioning

confidence: 99%

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Level of Adherence to the Gold Strategy Document for the Management of Patients with Acute Exacerbation of COPD in Sahiwal

Waseem,

Hamza,

Virk

et al. 2023

J Fatima Jinnah Med Univ

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Background: Chronic Obstructive Pulmonary Disease (COPD) and its exacerbation are a major cause of pulmonology OPD and emergency visits in Pakistan. The objective of this study was to measure the level of adherence to the GOLD (Global Initiative for Chronic Obstructive Lung Disease) strategy document in the management of patients with acute exacerbation of COPD, in Sahiwal Punjab Pakistan. Methodology: This retrospective cross-sectional study comprised 480 patients with acute exacerbation of COPD. It was conducted in the Pulmonology Department DHQ Teaching Hospital, Sahiwal. The treatment given to these patients was compared to treatment guidelines mentioned in the GOLD strategy document for management of acute exacerbation of COPD. Results: Out of total 480 patients, 408 (85%) were males. 312 (65%) patients belonged to age group 50-70 years. 100% Gold strategy treatment standards were not followed in any patient. Five out of ten management steps were followed in all cases. While remaining five steps were followed variably. Conclusion: Overall adherence to the AECOPD management standards set by GOLD strategy document was not good. Improved physician’s awareness of guidelines and better adherence to treatment standards can improve patient care and outcome.

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Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

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Level of Adherence to the Gold Strategy Document for the Management of Patients with Acute Exacerbation of COPD in Sahiwal

Waseem,

Hamza,

Virk

et al. 2023

J Fatima Jinnah Med Univ

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“…Despite general acceptance of clinical practice recommendations among clinicians, discordance with real-world practice has been similarly observed across different countries and diverse healthcare settings. A study conducted in Spain found that more than 50% of patients were receiving treatments that were not concordant with the GOLD strategy ( 11 ). Similarly, prescribing practices for COPD treatment amongst primary care doctors in the United Kingdom were found to be largely discordant with GOLD and National Institute for Health and Care Excellence recommendations ( 12 ).…”

Section: Discussionmentioning

confidence: 99%

A comparison of GOLD 2019 and 2023 recommendations to contemporaneous real-world inhaler treatment patterns for chronic obstructive pulmonary disease management in Singapore

Alsuwaigh,

Yii,

Loh

et al. 2024

J Thorac Dis

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Background In 2019 and 2023, the Global Initiative for Chronic Obstructive Lung Disease (GOLD) provided updated strategies for modifying the therapy of patients with chronic obstructive pulmonary disease (COPD) and high exacerbation risk. A key update since the 2019 guidelines recommends considering blood eosinophil count to guide decisions on inhaled corticosteroid (ICS) treatment. To evaluate the potential impact of these updated recommendations, this study aimed to assess how extensively future practice would diverge from contemporaneous prescribing practices at a single center in Singapore, assuming adherence to the 2019 and 2023 GOLD guidelines. Methods Retrospective cohort analysis of the Changi General Hospital COPD data warehouse involving patients aged ≥40 years hospitalized for a COPD exacerbation (October 2018–April 2020) receiving long-acting muscarinic antagonist (LAMA), LAMA plus a long-acting beta2-agonist (LABA), or an ICS plus LABA at admission. The proportion of patients eligible for treatment escalations per GOLD 2019 and 2023 recommendations was calculated. Results In total, 268 patients were included (mean age 73 years; 91% male). At admission, 19%, 59%, and 22% of patients were receiving LAMA, LAMA + LABA, and ICS + LABA, respectively. Overall, 226 patients would have been eligible for treatment escalation per GOLD 2019 or 2023 recommendations; 31 (13.7%) had treatment escalations consistent with GOLD 2019 guidelines and 34 (15%) received treatment escalations consistent with GOLD 2023 guidelines. A total of 205 patients (76.5%) remained on the same treatment regimen at hospital discharge as they were receiving at admission. Lower measured post-bronchodilator forced expiratory volume in 1 second was associated with treatment escalations that would have been GOLD-concordant (P=0.028), as was increased number of emergency department/hospital visits in the last year (P=0.048). Conclusions Compared with real-world clinical practice, a significantly higher proportion of patients may be eligible for treatment escalation under the GOLD 2019 and 2023 eosinophil-directed algorithms.

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Pharmaceutical treatment status of patients with COPD in the community based on medical Internet of Things: a real-world study

Wu,

Jiang,

et al. 2024

npj Prim. Care Respir. Med.

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This study aimed to investigate the real-world standardisation and adherence of medical treatment regimens in patients with chronic obstructive pulmonary disease (COPD) in the community for making future management strategy. The follow-up data and treatment information of patients with COPD, which were collected through the Management Information Center of COPD (MICCOPD) in 21 community health service centres in Songjiang District, a countryside region of Shanghai. Concordance between the pharmaceutical treatment plan and recommendation of 2017 Global Initiative for Chronic Obstructive Lung Disease (GOLD) report during the follow-up management period, as well as the medication adherence by patients,were analysed. Out of the 2044 patients diagnosed with COPD, 814 patients (39.8%) who had an initial record of medication use were found to meet the inclusion criteria. The most common medication regimens were long-acting beta-agonist plus inhaled corticosteroids (35.9%) and oral bronchodilators (41.9%). Among these 814 patients, 45.7%, 38.0%, 31.6% and 14.6% adhered to the treatment after 6, 12, 18 and 24 months of follow-up, respectively. The concordance rate with the regimens recommended by the 2017 GOLD guidelines was 35.5% at baseline, 35.5% at 6 months, 32.7% at 12 months, 35.4% at 18 months and 37% at 24 months. The compliance and guideline consistency rates of patients with COPD in the community under the management of general practitioners need to be improved. Enhancing general practitioner proficiency in the prevention and management of COPD and increasing patient awareness of the condition, are crucial standardising and improving adherence to initial and follow-up COPD treatments.

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Economic Impact of Low Adherence to COPD Management Guidelines in Spain

Cited by 5 publications

References 41 publications

Level of Adherence to the Gold Strategy Document for the Management of Patients with Acute Exacerbation of COPD in Sahiwal

Level of Adherence to the Gold Strategy Document for the Management of Patients with Acute Exacerbation of COPD in Sahiwal

A comparison of GOLD 2019 and 2023 recommendations to contemporaneous real-world inhaler treatment patterns for chronic obstructive pulmonary disease management in Singapore

Pharmaceutical treatment status of patients with COPD in the community based on medical Internet of Things: a real-world study

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