The impact of the Global Initiative on Chronic Obstructive Pulmonary Disease(GOLD)in 2023 on inhalation medication prescriptions
Objective To compare the differences in inhaled medication prescriptions among patients with chronic obstructive pulmonary disease(COPD)who visited the Global Initiative for Chronic Obstructive Pulmonary Disease(GOLD 2023)one year after its release and the previous year,and to analyze the impact of GOLD 2023 on physician inhaled medication prescriptions.Methods This study was a cross-sectional study,with data sourced from the RealDTC study.The study subjects were chronic obstructive pulmonary disease patients who visited the respiratory and critical care departments of 13 hospitals in southern China from November 14,2021 to November 15,2023.According to the time of patient visits,they are divided into the following two groups:the group 1 year before the release of GOLD 2023(November 14,2021 to November 14,2022),and the group 1 year after the release of GOLD 2023(November 15,2022 to November 15,2023).We collected demographic characteristics,lung function,symptom scores,history of acute exacerbation in the past year,and inhaled medication prescriptions from patients.According to the symptom score of COPD patients in GOLD 2023 and their history of acute exacerbation in the past year,they were divided into three groups:A,B,and E.The treatment status of inhaled drugs in groups A,B,and E before and after the release of GOLD 2023 was compared.Results There were statistically significant differences in COPD Assessment Test(CAT)scores,Modified Medical Research Council(mMRC)scores,and the number of acute exacerbations in the past year between patients with COPD before and after the release of GOLD 2023(all P＜0.05).Compared with the group one year before the release of GOLD 2023,the proportion of patients in the group one year after the release of GOLD 2023 using long-acting muscarinic antagonists(LAMA)and inhaled corticosteroids(ICS)+long-acting β2-receptor agonists(LABA)was lower,while the proportion of patients using LABA+LAMA and ICS+LABA+LAMA was higher(all P＜0.05).There was no statistically significant difference(P＞0.05)in the proportion of patients in group A using LAMA between the year before and after the release of GOLD 2023.Compared to the year before the release of GOLD 2023,the proportion of patients in group A who prescribed ICS+LABA was lower,while the proportion of using LABA+LAMA and ICS+LABA+LAMA was higher(all P＜0.05);The proportion of patients in group B who prescribed LAMA and ICS+LABA was lower(all P＜0.05),while the proportion of using LABA+LAMA and ICS+LABA+LAMA was higher(all P＜0.05);The proportion of patients in group E who prescribed LAMA and ICS+LABA was lower(all P＜0.05),while the proportion of using LABA+LAMA and ICS+LABA+LAMA was higher(all P＜0.05).Conclusions After the release of GOLD 2023,the prescription of ICS+LAMA in groups A,B,and E decreased,and the prescriptions of LABA+LAMA and ICS+LABA+LAMA increased compared to before;However,in the real world,the compliance of physicians with GOLD 2023 is still not ideal.
Pulmonary disease,chronic obstructiveAdministration,inhalationGlobal Initiative for Chronic Obstructive Lung Disease
NETL
NSTL
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