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A Review of the GOLD Guidelines for the Diagnosis and Treatment of Patients With COPD: Discussion



Smoking-related COPD is the most common form of chronic lung disease worldwide, and morbidity and mortality rates are alarmingly high worldwide and have continued to increase, unlike the rates associated with other diseases, such as coronary heart disease, stroke and cancer. COPD is a progressive disease, and unfortunately, symptoms are frequently absent in the early stages of COPD when treatment would be most beneficial in terms of preserving lung function and slowing the decline in patient health and QoL. Nevertheless, early recognition and diagnosis of COPD are critical components to achieving optimal treatment outcomes. Therefore, healthcare providers need to be aware of the hallmark characteristics of COPD diagnostic tests, including spirometry, to confirm clinical suspicions that will enhance the likelihood of early detection and lead to earlier implementation of disease management strategies.

Guidelines, such as the 2006 GOLD guidelines,[1] are readily available to healthcare professionals and are intended to increase awareness of COPD and improve prevention and management strategies. Updated and revised on a regular basis, these evidence-based guidelines provide the most current information about effective pharmacologic and non-pharmacologic treatments for COPD. Physician awareness of, and compliance with, the existing COPD guidelines, particularly with regard to selecting appropriate treatment strategies, can lead to more effective disease management for COPD patients, thereby delaying lung function decline, improving COPD symptoms, and enhancing the patient's overall QoL. Fortunately, a variety of pharmacologic agents, such as bronchodilators, anticholinergics, methylxanthines and corticosteroids, are available that when given alone or in combination to patients with all stages of COPD will improve lung function, reduce the symptoms and acute exacerbations of COPD, and improve outcomes for millions of patients.

However, awareness and understanding of COPD need to increase, especially in primary-care settings where the majority of undiagnosed patients with COPD will initially be seen and most of the patient care administered. Healthcare providers must therefore be committed to disseminating and implementing evidence-based guidelines into their everyday clinical practices if the current trends of increased morbidity and mortality associated with COPD are to be reversed.[13]

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