ArticleEClinicalMedicine2019
Distribution, Temporal Stability and Appropriateness of Therapy of Patients With COPD in the UK in Relation to GOLD 2019.
Article in EClinicalMedicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers.
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Who cites it
36 citing papers in PubMed.
- Prevalence of type 2 multimorbidities in COPD compared to asthma and relationship to blood eosinophilic counts.ERJ open research · 2026Article
- Pragmatic Evaluation of an Improvement Program for People Living With Modifiable High-Risk COPD Versus Usual Care: Protocols for the Cluster Randomized PREVAIL Trial.Chronic obstructive pulmonary diseases (Miami, Fla.) · 2025Article
- The management of type 2 inflammatory respiratory diseases: a Chinese expert consensus [2024].Journal of thoracic disease · 2025Review
- Development and Validation of a Quantitative Score for the Criteria Clinical Control in Stable COPD Proposed in the Spanish COPD Guidelines (GesEPOC): Results of the EPOCONSUL Audit.Journal of clinical medicine · 2025Article
- Clinical and Economic Evaluation of Fluticasone Furoate/Umeclidinium/Vilanterol Versus Tiotropium/Olodaterol Therapy in Maintenance Treatment-Naive Patients with COPD in the US.International journal of chronic obstructive pulmonary disease · 2025Observational
- Characteristics and actions in high-risk COPD in unstable patients: The EPOCONSUL audit.PloS one · 2025Article
- Article
- Exacerbation history and blood eosinophil count prior to diagnosis of COPD and risk of subsequent exacerbations.The European respiratory journal · 2024Article
- Budesonide/Glycopyrrolate/Formoterol for the Management of COPD in a UK Primary Care Population: Real-World Use and Early Medication Success.International journal of chronic obstructive pulmonary disease · 2024Observational
- Identification of key opportunities for optimising the management of high-risk COPD patients in the UK using the CONQUEST quality standards: an observational longitudinal study.The Lancet regional health. Europe · 2023Article
- Clinical Management of COPD in the Real World: Can Studies Reveal Errors in Management and Pathways to Improve Patient Care?Pragmatic and observational research · 2023Review
- Exploring the Validity of GOLD 2023 Guidelines: Should GOLD C and D Be Combined?International journal of chronic obstructive pulmonary disease · 2023Article
- Experience on the Management of Patients with Asthma or Chronic Obstructive Pulmonary Disease During the COVID-19 Pandemic: the NEUMOBIAL Study.Advances in therapy · 2022Article
- Characterisation of patients with chronic obstructive pulmonary disease initiating single-device inhaled corticosteroids/long-acting βBMJ open respiratory research · 2022Article
- Article
- Quality Standard Position Statements for Health System Policy Changes in Diagnosis and Management of COPD: A Global Perspective.Advances in therapy · 2022Article
- Treatment Transitions in Chronic Obstructive Pulmonary Disease: Retrospective Analyses of US and UK Healthcare Databases.Pulmonary therapy · 2022Article
- Costs and Clinical Consequences of Compliance with COPD GOLD Recommendations or National Guidelines Compared with Current Clinical Practice in Belgium, Germany, Sweden, and the United States.International journal of chronic obstructive pulmonary disease · 2022Article
- Variation in Demographic and Clinical Characteristics of Patients with COPD Receiving Care in US Primary Care: Data from the Advancing the Patient EXperience (APEX) in COPD Registry.Pragmatic and observational research · 2022Article
- Patients with Chronic Obstructive Pulmonary Disease and Evidence of Eosinophilic Inflammation Experience Exacerbations Despite Receiving Maximal Inhaled Maintenance Therapy.International journal of chronic obstructive pulmonary disease · 2022Observational
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Authors and funding
5 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundThe 2019 Global Initiative for Chronic Obstructive Lung Disease (GOLD) report made recommendations for the assessment, initial and subsequent treatment chronic obstructive pulmonary disease (COPD) based on biomarkers, including blood eosinophil counts.
methodsWe evaluated the distribution of UK COPD patients initiating maintenance therapy and established patients by GOLD group, the prevalence of comorbidities and appropriateness of therapy using electronic patient records from the Optimum Patient Care Research Database (OPCRD). Changes in effective GOLD group, therapy and exacerbation rates over the next 2 years were analysed.
findings11,409 established COPD patients and 699 starting therapy were studied. 44·3%, 25·7%, 13·8% & 16·2% of established COPD patients and 45·2%, 28·5%, 15·7% & 10·6% initiating therapy were in GOLD groups A, B, C & D respectively.The overall proportion in each GOLD group was similar after 2 years but there was substantial movement of patients between groups. Diabetes and cardiovascular disease were the most common comorbidities in all groups in both cohorts.LAMA monotherapy was the commonest initial therapy in all GOLD groups. In both cohorts there was over-treatment with escalation, de-escalation or switching in nearly 50% during follow-up.In both cohorts, exacerbation rates were highest in group D and appeared higher in over-treated patients.
interpretationMost patients are not at risk of exacerbations and co-morbidities are common. Many patients change effective GOLD group and therapy over time. Prescribing is not in accordance with guideline recommendations and many patients still appear over treated.
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