Skip to main content
Top
Published in: BMC Pulmonary Medicine 1/2021

Open Access 01-12-2021 | Chronic Obstructive Lung Disease | Research

Classification of COPD patients and compliance to recommended treatment in Greece according to GOLD 2017 report: the RELICO study

Authors: Nikolaos Tzanakis, Nikolaos Koulouris, Katerina Dimakou, Konstantinos Gourgoulianis, Epameinondas Kosmas, Georgia Chasapidou, Athanasios Konstantinidis, Christos Kyriakopoulos, Theodoros Kontakiotis, Aggeliki Rapti, Mina Gaga, Konstantinos Kalafatakis, Konstantinos Kostikas

Published in: BMC Pulmonary Medicine | Issue 1/2021

Login to get access

Abstract

Background

Chronic obstructive pulmonary disease (COPD) is a multifactorial clinical condition, characterized by chronic progressive (or worsening) respiratory symptoms, structural pulmonary abnormalities, and impaired lung function, and is often accompanied by multiple, clinically significant comorbid disorders. In 2017, the Global Initiative for Chronic Obstructive Lung Disease (GOLD) issued a new report on COPD prevention, diagnosis and management, aiming at personalizing the maintenance therapeutic approach of the stable disease, based on the patients’ symptoms and history of exacerbations (ABCD assessment approach). Our objective was to evaluate the implementation of GOLD suggestions in everyday clinical practice in Greece.

Methods

This was a cross-sectional observational study. Sixty-five different variables (demographics, vital sign measurements, COPD-related medical history parameters, comorbidities, vaccination data, COPD severity based on spirometry measurements, COPD stage based on the ABCD assessment approach, COPD treatments) were collected from 3615 nation-wide COPD patients (Greece).

Results

The mean age at the time of initial COPD diagnosis was 63.8 (± 10.2). Almost 60% of the subjects were classified into group B, while the remaining patients were falling into groups A (18%) and D (21%), and only a small minority of patients belonged to Group C, according to the ABCD assessment approach. The compliance of respiratory physicians to the GOLD 2017 therapeutic suggestions is problematic, especially when it comes to COPD patients belonging to Group A.

Conclusion

Our data provide valuable information regarding the demographic and medical profile of COPD patients in Greece, the domains which the revised ABCD assessment approach may show some clinical significance on, and the necessity for medical practitioners dealing with COPD patients to adhere closer to international recommendations for the proper management of the disease.
Appendix
Available only for authorised users
Literature
1.
go back to reference Agustí A, Hogg JC. Update on the pathogenesis of chronic obstructive pulmonary disease. N Engl J Med. 2019;381(13):1248–56.CrossRef Agustí A, Hogg JC. Update on the pathogenesis of chronic obstructive pulmonary disease. N Engl J Med. 2019;381(13):1248–56.CrossRef
2.
go back to reference Antó JM, Vermeire P, Vestbo J, Sunyer J. Epidemiology of chronic obstructive pulmonary disease. Eur Respir J. 2001;17(5):982–94.CrossRef Antó JM, Vermeire P, Vestbo J, Sunyer J. Epidemiology of chronic obstructive pulmonary disease. Eur Respir J. 2001;17(5):982–94.CrossRef
3.
go back to reference Maselli DJ, Bhatt SP, Anzueto A, Bowler RP, DeMeo DL, Diaz AA, et al. Clinical epidemiology of COPD: insights from 10 years of the COPDGene study. Chest. 2019;156(2):228–38.CrossRef Maselli DJ, Bhatt SP, Anzueto A, Bowler RP, DeMeo DL, Diaz AA, et al. Clinical epidemiology of COPD: insights from 10 years of the COPDGene study. Chest. 2019;156(2):228–38.CrossRef
4.
go back to reference Fang L, Gao P, Bao H, Tang X, Wang B, Feng Y, et al. Chronic obstructive pulmonary disease in China: a nationwide prevalence study. Lancet Respir Med. 2018;6(6):421–30.CrossRef Fang L, Gao P, Bao H, Tang X, Wang B, Feng Y, et al. Chronic obstructive pulmonary disease in China: a nationwide prevalence study. Lancet Respir Med. 2018;6(6):421–30.CrossRef
5.
go back to reference Blanco I, Diego I, Bueno P, Fernández E, Casas-Maldonado F, Esquinas C, et al. Geographical distribution of COPD prevalence in Europe, estimated by an inverse distance weighting interpolation technique. Int J Chron Obstruct Pulmon Dis. 2018;13:57–67.CrossRef Blanco I, Diego I, Bueno P, Fernández E, Casas-Maldonado F, Esquinas C, et al. Geographical distribution of COPD prevalence in Europe, estimated by an inverse distance weighting interpolation technique. Int J Chron Obstruct Pulmon Dis. 2018;13:57–67.CrossRef
6.
go back to reference GBD 2015 Chronic Respiratory Disease Collaborators. Global, regional, and national deaths, prevalence, disability-adjusted life years, and years lived with disability for chronic obstructive pulmonary disease and asthma, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet Respir Med. 2017;5(9):691–706. GBD 2015 Chronic Respiratory Disease Collaborators. Global, regional, and national deaths, prevalence, disability-adjusted life years, and years lived with disability for chronic obstructive pulmonary disease and asthma, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet Respir Med. 2017;5(9):691–706.
7.
go back to reference Rabe KF, Hurd S, Anzueto A, Barnes PJ, Buist SA, Calverley P, et al. Global strategy for the diagnosis, management and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med. 2007;176(6):532–55.CrossRef Rabe KF, Hurd S, Anzueto A, Barnes PJ, Buist SA, Calverley P, et al. Global strategy for the diagnosis, management and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med. 2007;176(6):532–55.CrossRef
8.
go back to reference Vestbo J, Hurd SS, Agusti AG, Jones PW, Vogelmeier C, Anzueto A, et al. Global strategy for the diagnosis management and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med. 2013;187(4):Q347-365.CrossRef Vestbo J, Hurd SS, Agusti AG, Jones PW, Vogelmeier C, Anzueto A, et al. Global strategy for the diagnosis management and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med. 2013;187(4):Q347-365.CrossRef
9.
go back to reference Vogelmeier CF, Criner GJ, Martinez FJ, Anzueto A, Barnes PJ, Bourbeau J, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive lung disease 2017 report: GOLD executive summary. Am J Respir Crit Care Med. 2017;195(5):557–82.CrossRef Vogelmeier CF, Criner GJ, Martinez FJ, Anzueto A, Barnes PJ, Bourbeau J, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive lung disease 2017 report: GOLD executive summary. Am J Respir Crit Care Med. 2017;195(5):557–82.CrossRef
10.
go back to reference Tzanakis N, Anagnostopoulou U, Filaditaki V, Christaki P, Siafakas N. Prevalence of COPD in Greece. Chest. 2004;125(3):892–900.CrossRef Tzanakis N, Anagnostopoulou U, Filaditaki V, Christaki P, Siafakas N. Prevalence of COPD in Greece. Chest. 2004;125(3):892–900.CrossRef
11.
go back to reference Sichletidis L, Tsiotsios I, Gavriilidis A, Chloros D, Kottakis I, Daskalopoulou E, Konstantinidis T. Prevalence of chronic obstructive pulmonary disease and rhinitis in northern Greece. Respiration. 2005;72(3):270–7.CrossRef Sichletidis L, Tsiotsios I, Gavriilidis A, Chloros D, Kottakis I, Daskalopoulou E, Konstantinidis T. Prevalence of chronic obstructive pulmonary disease and rhinitis in northern Greece. Respiration. 2005;72(3):270–7.CrossRef
12.
go back to reference Minas M, Hatzoglou C, Karetsi E, Papaioannou AI, Tanou K, Tsaroucha R, et al. COPD prevalence and the differences between newly and previously diagnosed COPD patients in a spirometry program. Prim Care Respir J. 2010;19(4):363–70.CrossRef Minas M, Hatzoglou C, Karetsi E, Papaioannou AI, Tanou K, Tsaroucha R, et al. COPD prevalence and the differences between newly and previously diagnosed COPD patients in a spirometry program. Prim Care Respir J. 2010;19(4):363–70.CrossRef
13.
go back to reference Singh D, Agusti A, Anzueto A, Barnes PJ, Bourbeau J, Celli BR, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive lung disease: the GOLD science committee report 2019. Eur Respir J. 2019;53(5):1900164.CrossRef Singh D, Agusti A, Anzueto A, Barnes PJ, Bourbeau J, Celli BR, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive lung disease: the GOLD science committee report 2019. Eur Respir J. 2019;53(5):1900164.CrossRef
14.
go back to reference Mirza S, Clay RD, Koslow MA, Scanlon PD. COPD guidelines: a review of the 2018 GOLD report. Mayo Clin Proc. 2018;93(10):1488–502.CrossRef Mirza S, Clay RD, Koslow MA, Scanlon PD. COPD guidelines: a review of the 2018 GOLD report. Mayo Clin Proc. 2018;93(10):1488–502.CrossRef
15.
go back to reference Vestbo J, Vogelmeier CF, Small M, Siddall J, Fogel R, Kostikas K. Inhaled corticosteroid use by exacerbations and eosinophils: a real-world COPD population. Int J Chron Obstruct Pulmon Dis. 2019;14:853–61.CrossRef Vestbo J, Vogelmeier CF, Small M, Siddall J, Fogel R, Kostikas K. Inhaled corticosteroid use by exacerbations and eosinophils: a real-world COPD population. Int J Chron Obstruct Pulmon Dis. 2019;14:853–61.CrossRef
16.
go back to reference Cui Y, Dai Z, Luo L, Chen P, Chen Y. Classification and treatment of chronic obstructive pulmonary disease outpatients in China according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2017: comparison with GOLD 2014. J Thorac Dis. 2019;11(4):1303–15.CrossRef Cui Y, Dai Z, Luo L, Chen P, Chen Y. Classification and treatment of chronic obstructive pulmonary disease outpatients in China according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2017: comparison with GOLD 2014. J Thorac Dis. 2019;11(4):1303–15.CrossRef
17.
go back to reference Tudoric N, Koblizek V, Miravitlles M, Valipour A, Milenkovic B, Barczyk A, et al. GOLD 2017 on the way to a phenotypic approach? Analysis from the Phenotypes of COPD in Central and Eastern Europe (POPE) Cohort. Eur Respir J. 2017;49(4):1602518.CrossRef Tudoric N, Koblizek V, Miravitlles M, Valipour A, Milenkovic B, Barczyk A, et al. GOLD 2017 on the way to a phenotypic approach? Analysis from the Phenotypes of COPD in Central and Eastern Europe (POPE) Cohort. Eur Respir J. 2017;49(4):1602518.CrossRef
18.
go back to reference Duarte-de-Araújo A, Teixeira P, Hespanhol V, Correia-de-Sousa P. COPD: analysing factors associated with a successful treatment. Pulmonology. 2020;26(2):66–72.CrossRef Duarte-de-Araújo A, Teixeira P, Hespanhol V, Correia-de-Sousa P. COPD: analysing factors associated with a successful treatment. Pulmonology. 2020;26(2):66–72.CrossRef
19.
go back to reference Rajnoveanu RM, Rajnoveanu AG, Ardelean AB, Todea DA, Pop CM, Antoniu SA, et al. Pulmonologists adherence to the chronic obstructive pulmonary disease GOLD Guidelines: a goal to improve. Medicina (Kaunas). 2020;56(9):422.CrossRef Rajnoveanu RM, Rajnoveanu AG, Ardelean AB, Todea DA, Pop CM, Antoniu SA, et al. Pulmonologists adherence to the chronic obstructive pulmonary disease GOLD Guidelines: a goal to improve. Medicina (Kaunas). 2020;56(9):422.CrossRef
20.
go back to reference Grewe FA, Sievi NA, Bradicich M, Roeder M, Brack T, Brutsche MH, et al. Compliance of pharmacotherapy with GOLD guidelines: a longitudinal study in patients with COPD. Int J Chron Obstruct Pulmon Dis. 2020;15:627–35.CrossRef Grewe FA, Sievi NA, Bradicich M, Roeder M, Brack T, Brutsche MH, et al. Compliance of pharmacotherapy with GOLD guidelines: a longitudinal study in patients with COPD. Int J Chron Obstruct Pulmon Dis. 2020;15:627–35.CrossRef
21.
go back to reference Marmy JL, Diedrich JP, Cadus C, Grendelmeier P, Tschacher A, Dieterle T, et al. Adherence to GOLD recommendations among Swiss pulmonologists and general practitioners. COPD. 2021;18(1):9–15.CrossRef Marmy JL, Diedrich JP, Cadus C, Grendelmeier P, Tschacher A, Dieterle T, et al. Adherence to GOLD recommendations among Swiss pulmonologists and general practitioners. COPD. 2021;18(1):9–15.CrossRef
22.
go back to reference Radovanovic D, Contoli M, Di Marco F, Sotgiu G, Pelaia G, Braido F, et al. Clinical and functional characteristics of COPD patients across GOLD classifications: results of a multicenter observational study. COPD. 2019;16(3–4):215–26.CrossRef Radovanovic D, Contoli M, Di Marco F, Sotgiu G, Pelaia G, Braido F, et al. Clinical and functional characteristics of COPD patients across GOLD classifications: results of a multicenter observational study. COPD. 2019;16(3–4):215–26.CrossRef
Metadata
Title
Classification of COPD patients and compliance to recommended treatment in Greece according to GOLD 2017 report: the RELICO study
Authors
Nikolaos Tzanakis
Nikolaos Koulouris
Katerina Dimakou
Konstantinos Gourgoulianis
Epameinondas Kosmas
Georgia Chasapidou
Athanasios Konstantinidis
Christos Kyriakopoulos
Theodoros Kontakiotis
Aggeliki Rapti
Mina Gaga
Konstantinos Kalafatakis
Konstantinos Kostikas
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Pulmonary Medicine / Issue 1/2021
Electronic ISSN: 1471-2466
DOI
https://doi.org/10.1186/s12890-021-01576-6

Other articles of this Issue 1/2021

BMC Pulmonary Medicine 1/2021 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine