Agreement between a simple dyspnea-guided treatment algorithm for stable COPD and the GOLD guidelines: a pilot study

Abstract

Introduction

Guidelines recommendations for the treatment of COPD are poorly followed. This could be related to the complexity of classification and treatment algorithms. The purpose of this study was to validate a simpler dyspnea-based treatment algorithm for inhaled pharmacotherapy in stable COPD, comparing its concordance with the current Global Initiative for Obstructive Lung Disease (GOLD) guideline.

Methods

We enrolled patients who had been diagnosed with COPD in three primary care facilities and two tertiary hospitals in Spain. We determined anthropometric data, forced expiratory volume in the 1st second (percent), exacerbations, and dyspnea based on the modified Medical Research Council scale. We evaluated the new algorithm based on dyspnea and exacerbations and calculated the concordance with the current GOLD recommendations.

Results

We enrolled 100 patients in primary care and 150 attending specialized care in a respiratory clinic. There were differences in the sample distribution between cohorts with 41% vs 26% in grade A, 16% vs 12% in grade B, 16% vs 22% in grade C, and 27% vs 40% in grade D for primary and respiratory care, respectively ( P=0.005). The coincidence of the algorithm with the GOLD recommendations in primary care was 93% and 91.8% in the respiratory care cohort.

Conclusion

A simple dyspnea-based treatment algorithm for inhaled pharmacotherapy of COPD could be useful in the management of COPD patients and concurs very well with the recommended schema suggested by the GOLD initiative.

Journal

Journal ID (nlm-ta): Int J Chron Obstruct Pulmon Dis

Journal ID (iso-abbrev): Int J Chron Obstruct Pulmon Dis

Journal ID (publisher-id): International Journal of COPD

Title: International Journal of Chronic Obstructive Pulmonary Disease

Publisher: Dove Medical Press

ISSN (Print): 1176-9106

ISSN (Electronic): 1178-2005

Publication date Collection: 2016

Publication date (Electronic): 08 June 2016

Volume: 11

Pages: 1217-1222

Affiliations

[1 ]University Hospital of Gran Canaria Dr Negrín, Respiratory Service, Las Palmas de Gran Canaria, Spain

[2 ]University Hospital Nuestra Señora de la Candelaria, Respiratory Service, Santa Cruz de Tenerife, Spain

[3 ]Arucas Health Center, Primary Care Las Palmas de Gran Canaria, Spain

[4 ]Cueva Torres Health Center, Primary Care Las Palmas de Gran Canaria, Spain

[5 ]La Feria Health Center, Primary Care Las Palmas de Gran Canaria, Spain

[6 ]University Hospital of Gran Canaria Dr Negrín, Investigation Unit, Las Palmas de Gran Canaria, Spain

[7 ]University Hospital Miguel Servet, Respiratory Service, Zaragoza, Spain

[8 ]Navarra University Clinic, Respiratory Service, Pamplona, Spain

[9 ]Brigham and Women’s Hospital, Pulmonary and Critical Care Service, Boston, MA, USA

Author notes

Correspondence: Carlos Cabrera, University Hospital of Gran Canaria Dr Negrín, Respiratory Service, la Ballena S/N, 35010 Las Palmas de Gran Canaria, Spain, Email ccablopn@ 123456gmail.com

Article

Publisher ID: copd-11-1217

DOI: 10.2147/COPD.S100853

PMC ID: 4907482

PubMed ID: 27354780

Copyright statement: © 2016 Cabrera et al. This work is published and licensed by Dove Medical Press Limited

License:

The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

Categories

Subject: Original Research