Adherence to Inhaled Medication Guidelines in Patients with COPD: Evaluating the GOLD 2023 Strategy in a Real-World Secondary Care Setting

作者：Liz Cuperus, Gina De Jong, Erik Bischoff, Job F. M. van Boven, Job van der Palen, Joachim G.J.V. Aerts, Huib A.M. Kerstjens, J.C.C.M. in ’t Veen · 发表于：International Journal of COPD · 年份：2025 · DOI：10.2147/copd.s543458 · 被引用次数：4 · 研究领域：Chronic Obstructive Pulmonary Disease (COPD) Research、Medication Adherence and Compliance、Respiratory and Cough-Related Research

Introduction: The 2023 Global Initiative for Chronic Obstructive Lung Disease (GOLD) strategy introduced updates to the prescription of inhaled medication, including withdrawing recommendation of long-acting beta-agonist/inhaled corticosteroids (LABA/ICS) as double therapy, restricting ICS use to patients with exacerbations, and recommending earlier escalation to triple therapy. These changes are expected to have a substantial impact on clinical practice. This study aims to describe how well clinicians adhere to the GOLD strategy in daily practice, and to explore the extent to which the 2023 update has changed prescribing patterns. Methods: Data were collected from a real-world cohort at a teaching hospital in the Netherlands in 2022, and the same cohort was reassessed in 2023. To determine guideline adherence, each patient's treatment was assessed against the applicable GOLD strategy at that time. Subgroups that did not receive treatment according to the GOLD strategy were identified. Finally, a more detailed assessment of ICS prescriptions and their indications was conducted. Results: A total of 1318 patients were included in 2022. In 2022, 51.6% received inhaled medication in line with the applicable GOLD strategy, compared to 57.3% in 2023 in accordance with that year's GOLD strategy. Patients with low eosinophils, those without exacerbations, and those with less severe GOLD classification were less frequently treated in accordance with the 2023 strategy. Overtreatment wi...