Vestbo, Jørgen3; Hurd, Suzanne S2; Agusti, Alvar G2; Jones, Paul W2; Vogelmeier, Claus2; Anzueto, Antonio2; Barnes, Peter J2; Fabbri, Leonardo M2; Martinez, Fernando J2; Nishimura, Masaharu2; Stockley, Robert A2; Sin, Don D2; Rodriguez-Roisin, Roberto2
1 Lung Medicine, Department of Clinical Research, Det Sundhedsvidenskabelige Fakultet, SDU2 unknown3 Lung Medicine, Department of Clinical Research, Det Sundhedsvidenskabelige Fakultet, SDU
Chronic obstructive pulmonary disease (COPD) is a global health problem and since 2001 the Global Initiative for Chronic Obstructive Lung Disease (GOLD) has published its strategy document for the diagnosis and management of COPD. This executive summary presents the main contents of the second 5-year revision of the GOLD document that has implemented some of the vast knowledge about COPD accumulated over the last years. Today, GOLD recommends that spirometry is required for the clinical diagnosis of COPD in order to avoid misdiagnosis and to ensure proper evaluation of severity of airflow limitation. The document highlights that the assessment of the COPD patient should always include assessment of 1) symptoms, 2) severity of airflow limitation, 3) history of exacerbations, and 4) comorbidities. The first three points can be used to evaluate level of symptoms and risk of future exacerbations and this is done in a way that split COPD patients into 4 categories - A, B, C and D. Non-pharmacologic and pharmacologic management of COPD match this assessment in an evidence-based attempt to relieve symptoms and reduce risk of exacerbations. Identification and treatment of comorbidities must have high priority and a separate chapter in the document addresses management of comorbidities as well as COPD in the presence of comorbidities. The revised document also contains a new chapter on exacerbations of COPD. The GOLD initiative will continue to bring COPD to the attention of all relevant shareholders and will hopefully inspire future national and local guidelines on the management of COPD.
American Journal of Respiratory and Critical Care Medicine, 2013, Vol 187, Issue 4, p. 347-365