Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

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.
ADVANCED SEARCH
Log in
Top
Respiratory Research
Published in: Respiratory Research 1/2018

Open Access 01-12-2018 | Review

Chronic obstructive pulmonary disease guidelines in Europe: a look into the future

Authors: Marc Miravitlles, Nicolas Roche, João Cardoso, David Halpin, Zaurbek Aisanov, Hannu Kankaanranta, Vladimir Kobližek, Paweł Śliwiński, Leif Bjermer, Michael Tamm, Francesco Blasi, Claus F. Vogelmeier

Published in: Respiratory Research | Issue 1/2018

Login to get access

Abstract

Clinical practice guidelines are ubiquitous and are developed to provide recommendations for the management of many diseases, including chronic obstructive pulmonary disease. The development of these guidelines is burdensome, demanding a significant investment of time and money. In Europe, the majority of countries develop their own national guidelines, despite the potential for overlap or duplication of effort. A concerted effort and consolidation of resources between countries may alleviate the resource-intensity of maintaining individual national guidelines. Despite significant resource investment into the development and maintenance of clinical practice guidelines, their implementation is suboptimal. Effective strategies of guideline dissemination must be given more consideration, to ensure adequate implementation and improved patient care management in the future.
Literature
1.
Overington JD, Huang YC, Abramson MJ, Brown JL, Goddard JR, Bowman RV, et al. Implementing clinical guidelines for chronic obstructive pulmonary disease: barriers and solutions. J Thorac Dis. 2014;6:1586–96.PubMedPubMedCentral
2.
Grimshaw JM, Thomas RE, MacLennan G, Fraser C, Ramsay CR, Vale L, et al. Effectiveness and efficiency of guideline dissemination and implementation strategies. Health Technol Assess. 2004;8:1–72.CrossRef
3.
Hughes LD, McMurdo ME, Guthrie B. Guidelines for people not for diseases: the challenges of applying UK clinical guidelines to people with multimorbidity. Age Ageing. 2013;42:62–9.CrossRefPubMed
4.
Wilt TJ, Guyatt G, Kunz R, Macnee W, Puhan MA, Viegi G, et al. Deciding what type of evidence and outcomes to include in guidelines: article 5 in integrating and coordinating efforts in COPD guideline development. An official ATS/ERS workshop report. Proc Am Thorac Soc. 2012;9:243–50.CrossRefPubMed
5.
Schunemann HJ, Oxman AD, Akl EA, Brozek JL, Montori VM, Heffner J, et al. Moving from evidence to developing recommendations in guidelines: article 11 in integrating and coordinating efforts in COPD guideline development. An official ATS/ERS workshop report. Proc Am Thorac Soc. 2012;9:282–92.CrossRefPubMed
6.
Schunemann HJ, Woodhead M, Anzueto A, Buist AS, Macnee W, Rabe KF, et al. A guide to guidelines for professional societies and other developers of recommendations: introduction to integrating and coordinating efforts in COPD guideline development. An official ATS/ERS workshop report. Proc Am Thorac Soc. 2012;9:215–8.CrossRefPubMed
7.
Atkins D, Best D, Briss PA, Eccles M, Falck-Ytter Y, Flottorp S, et al. Grading quality of evidence and strength of recommendations. BMJ. 2004;328:1490.CrossRefPubMed
8.
Guyatt GH, Oxman AD, Kunz R, Jaeschke R, Helfand M, Liberati A, et al. Incorporating considerations of resources use into grading recommendations. BMJ. 2008;336:1170–3.CrossRefPubMedPubMedCentral
9.
Guyatt GH, Oxman AD, Vist GE, Kunz R, Falck-Ytter Y, Alonso-Coello P, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ. 2008;336:924–6.CrossRefPubMedPubMedCentral
10.
Wong GW, Miravitlles M, Chisholm A, Krishnan JA. Respiratory guidelines - which real world? Ann Am Thorac Soc. 2014;11(Suppl 2):S85–91.CrossRefPubMed
11.
Croft P, Malmivaara A, van Tulder M. The pros and cons of evidence-based medicine. Spine. 2011;36:E1121–5.CrossRefPubMed
12.
Fabbri LM, Boschetto P, Mapp CE. COPD guidelines: the important thing is not to stop questioning. Am J Respir Crit Care Med. 2007;176:527–8.CrossRefPubMed
13.
Halpin DM, Kerkhof M, Soriano JB, Mikkelsen H, Price DB. Eligibility of real-life patients with COPD for inclusion in trials of inhaled long-acting bronchodilator therapy. Respir Res. 2016;17:120.CrossRefPubMedPubMedCentral
14.
Roche N, Reddel H, Martin R, Brusselle G, Papi A, Thomas M, et al. Quality standards for real-world research. Focus on observational database studies of comparative effectiveness. Ann Am Thorac Soc. 2014;11(Suppl 2):S99–104.CrossRefPubMed
15.
Laforest L, Roche N, Devouassoux G, Belhassen M, Chouaid C, Ginoux M, et al. Frequency of comorbidities in chronic obstructive pulmonary disease, and impact on all-cause mortality: a population-based cohort study. Respir Med. 2016;117:33–9.CrossRefPubMed
16.
Stone IS, Barnes NC, James W-Y, Midwinter D, Boubertakh R, Follows R, et al. Lung deflation and cardiovascular structure and function in chronic obstructive pulmonary disease. A randomized controlled trial. Am J Respir Crit Care Med. 2016;193:717–26.CrossRefPubMedPubMedCentral
17.
Livermore N, Butler JE, Sharpe L, McBain RA, Gandevia SC, McKenzie DK. Panic attacks and perception of inspiratory resistive loads in chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2008;178:7–12.CrossRefPubMed
18.
Miravitlles M, Price D, Rabe K, Schmidt H, Metzdorf N, Celli B. Comorbidities of patients in tiotropium clinical trials: comparison with observational studies of patients with chronic obstructive pulmonary disease. Int J Chron Obst Pulm Dis. 2015;10:549–64.CrossRef
19.
Boyd CM, Darer J, Boult C, Fried LP, Boult L, Wu AW. Clinical practice guidelines and quality of care for older patients with multiple comorbid diseases. JAMA. 2005;294:716–24.CrossRefPubMed
20.
Tinetti ME, Bogardus ST Jr, Agostini JV. Potential pitfalls of disease-specific guidelines for patients with multiple conditions. N Engl J Med. 2004;351:2870–4.CrossRefPubMed
21.
Vanfleteren LEGW, Spruit MA, Wouters EFM, Franssen FME. Management of chronic obstructive pulmonary disease beyond the lungs. Lancet Respir Med. 2016;4:911–24.CrossRefPubMed
22.
Hilbink MA, Ouwens MM, Burgers JS, Kool RB. A new impetus for guideline development and implementation: construction and evaluation of a toolbox. Implement Sci. 2014;9:34.CrossRefPubMedPubMedCentral
23.
Woolf SH, Grol R, Hutchinson A, Eccles M, Grimshaw J. Clinical guidelines: potential benefits, limitations, and harms of clinical guidelines. BMJ. 1999;318:527–30.CrossRefPubMedPubMedCentral
24.
Boyd EA, Akl EA, Baumann M, Curtis JR, Field MJ, Jaeschke R, et al. Guideline funding and conflicts of interest: article 4 in integrating and coordinating efforts in COPD guideline development. An official ATS/ERS workshop report. Proc Am Thorac Soc. 2012;9:234–42.CrossRefPubMed
25.
Schoenberg NC, Barker AF, Bernardo J, Deterding RR, Ellner JJ, Hess DR, et al. A comparative analysis of pulmonary and critical care medicine guideline development methodologies. Am J Respir Crit Care Med. 2017;196:621–7.CrossRefPubMed
26.
Yawn BP, Akl EA, Qaseem A, Black P, Campos-Outcalt D. Identifying target audiences: who are the guidelines for? Integrating and coordinating efforts in COPD guideline development. An official ATS/ERS workshop report. Proc Am Thorac Soc. 2012;9:219–24.CrossRefPubMed
27.
Mapel D, Pearson M. Obtaining evidence for use by healthcare payers on the success of chronic obstructive pulmonary disease management. Respir Med. 2002;96(Suppl C):S23–30.CrossRefPubMed
28.
Eccles MP, Grimshaw JM, Shekelle P, Schunemann HJ, Woolf S. Developing clinical practice guidelines: target audiences, identifying topics for guidelines, guideline group composition and functioning and conflicts of interest. Implement Sci. 2012;7:60.CrossRefPubMedPubMedCentral
29.
Bloomrosen M, Detmer DE. Informatics, evidence-based care, and research; implications for national policy: a report of an American medical informatics association health policy conference. J Am Med Inform Assoc. 2010;17:115–23.CrossRefPubMedPubMedCentral
30.
Calverley PM, Rennard SI. Application of management guidelines to the assessment of new medicines: driving us forward or holding us back? Eur Respir J. 2004;23:793–4.CrossRefPubMed
31.
Cluzeau F, Wedzicha JA, Kelson M, Corn J, Kunz R, Walsh J, et al. Stakeholder involvement: how to do it right: article 9 in integrating and coordinating efforts in COPD guideline development. An official ATS/ERS workshop report. Proc Am Thorac Soc. 2012;9:269–73.CrossRefPubMed
32.
Buist AS. Guidelines for the management of chronic obstructive pulmonary disease. Respir Med. 2002;96(Suppl C):S11–6.CrossRefPubMed
33.
Legare F, Boivin A, van der Weijden T, Pakenham C, Burgers J, Legare J, et al. Patient and public involvement in clinical practice guidelines: a knowledge synthesis of existing programs. Med Decis Mak. 2011;31:E45–74.CrossRef
34.
Miravitlles M, Vogelmeier C, Roche N, Halpin D, Cardoso J, Chuchalin AG, et al. A review of national guidelines for management of COPD in Europe. Eur Respir J. 2016;47:625–37.CrossRefPubMedPubMedCentral
35.
Alonso-Coello P, Martinez Garcia L, Carrasco JM, Sola I, Qureshi S, Burgers JS. The updating of clinical practice guidelines: insights from an international survey. Implement Sci. 2011;6:107.CrossRefPubMedPubMedCentral
36.
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. Eur Respir J. 2017;195:557–82.
37.
Brusselle GG, Gaga M. ERS guidelines, statements and technical standards published in the ERJ in 2014: a year in review. Eur Respir J. 2015;45:863–6.CrossRefPubMed
38.
Wedzicha JA, Calverley PM, Albert RK, Anzueto A, Criner GJ, Hurst JR, et al. Prevention of COPD exacerbations: an European Respiratory Society/American Thoracic Society (ERS/ATS) guideline. Eur Respir J. 2017;50:1602265.CrossRefPubMed
39.
Wedzicha JA, Miravitlles M, Hurst JR, Calverley PM, Albert RK, Anzueto A, et al. Management of COPD exacerbations: a European Respiratory Society/American Thoracic Society guideline. Eur Respir J. 2017;49:1600791.CrossRef
40.
Miravitlles M, Anzueto AA. New two-step algorithm for the treatment of COPD. Eur Respir J. 2017;49:1602200.CrossRefPubMed
41.
Kankaanranta H, Harju T, Kilpelainen M, Mazur W, Lehto JT, Katajisto M, et al. Diagnosis and pharmacotherapy of stable chronic obstructive pulmonary disease: the finnish guidelines. Basic Clin Pharmacol Toxicol. 2015;116:291–307.CrossRefPubMedPubMedCentral
42.
Salinas GD, Williamson JC, Kalhan R, Thomashow B, Scheckermann JL, Walsh J, et al. Barriers to adherence to chronic obstructive pulmonary disease guidelines by primary care physicians. Int J Chron Obstruct Pulmon Dis. 2011;6:171–9.CrossRefPubMedPubMedCentral
43.
Koblizek V, Chlumsky J, Zindr V, Neumannova K, Zatloukal J, Zak J, et al. Chronic obstructive pulmonary disease: official diagnosis and treatment guidelines of the Czech Pneumological and Phthisiological society; a novel phenotypic approach to COPD with patient-oriented care. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2013;157:189–201.PubMed
44.
National Institute for Health and Care Excellence UK: Chronic obstructive pulmonary disease: Management of Chronic Obstructive Pulmonary Disease in adults in primary and secondary care (partial Update). 2010. www.​nice.​org.​uk/​guidance/​cg101 Accessed 15 Sept 2017.
45.
Harju T, Kankaanranta H, Katajisto M, Kilpelainen M, Lehtimaki L, Lehto J, et al. Update on current care guideline: chronic obstructive pulmonary disease (COPD). Duodecim. 2014;130:1774–6.PubMed
46.
Zysman M, Chabot F, Devillier P, Housset B, Morelot-Panzini C, Roche N. Pharmacological treatment optimization for stable chronic obstructive pulmonary disease. Proposals from the Société de Pneumologie de langue Française. Rev Mal Respir. 2016;33:911–36.CrossRefPubMed
47.
Jouneau S, Chabot F, Roche N. New guidelines for acute COPD exacerbations. Rev Mal Respir. 2017;34:279–81.CrossRefPubMed
48.
Bettoncelli G, Blasi F, Brusasco V, Centanni S, Corrado A, De Benedetto F, et al. The clinical and integrated management of COPD. An official document of AIMAR (interdisciplinary Association for Research in lung disease), AIPO (Italian Association of Hospital Pulmonologists), SIMER (Italian Society of Respiratory Medicine), SIMG (Italian Society of General Medicine). Multidiscip Respir Med. 2014;9:25.CrossRefPubMedPubMedCentral
49.
Sliwinski P, Gorecka D, Jassem E, Pierzchala W. Polish respiratory society guidelines for chronic obstructive pulmonary disease. Pneumonol Alergol Pol. 2014;82:227–63.CrossRefPubMed
50.
51.
Aisanov Z, Avdeev S, Arkhipov V, Belevskiy A, Chuchalin A, Leshchenko I, et al. Russian guidelines for the management of COPD: algorithm of pharmacologic treatment. Int J Chron Obst Pulm Dis. 2018;13:183–187.
52.
Miravitlles M, Soler-Cataluña JJ, Calle M, Molina J, Almagro P, Quintano JA, et al. Spanish guidelines for Management of Chronic Obstructive Pulmonary Disease (GesEPOC) 2017. Pharmacological treatment of stable phase. Arch Bronconeumol. 2017;53:324–35.PubMed
53.
54.
55.
Russi EW, Karrer W, Brutsche M, Eich C, Fitting JW, Frey M, et al. Diagnosis and management of chronic obstructive pulmonary disease: the Swiss guidelines. Official guidelines of the Swiss respiratory society. Respiration. 2013;85:160–74.CrossRefPubMed
Metadata
Title
Chronic obstructive pulmonary disease guidelines in Europe: a look into the future
Authors
Marc Miravitlles
Nicolas Roche
João Cardoso
David Halpin
Zaurbek Aisanov
Hannu Kankaanranta
Vladimir Kobližek
Paweł Śliwiński
Leif Bjermer
Michael Tamm
Francesco Blasi
Claus F. Vogelmeier
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Respiratory Research / Issue 1/2018
Electronic ISSN: 1465-993X
DOI
https://doi.org/10.1186/s12931-018-0715-1

Other articles of this Issue 1/2018

Respiratory Research 1/2018 Go to the issue

Research

Upregulation of microRNA-17-5p contributes to hypoxia-induced proliferation in human pulmonary artery smooth muscle cells through modulation of p21 and PTEN

Research

The impact of HIV on the prevalence of asthma in Uganda: a general population survey

Research

Fibrocytes are increased in lung and peripheral blood of patients with idiopathic pulmonary fibrosis

Correction

Correction to: Comparative analysis of COPD associated with tobacco smoking, biomass smoke exposure or both

Research

Alterations in VASP phosphorylation and profilin1 and cofilin1 expression in hyperoxic lung injury and BPD

Research

Identification of deleterious and regulatory genomic variations in known asthma loci
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

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

Read more

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

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits