The Executive Summary for the latest edition of the GOLD global strategy on COPD has been published this week. It features significant changes in the areas of assessment, treatment and the importance of comorbidities.
The Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease 2017 is the main reference tool detailing current best practice for the care of people living with COPD.
The Executive Summary provides an overview of the revised and new parts of the global strategy. The most significant changes in the document include:
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The assessment of COPD has been refined to separate the spirometric assessment from symptom evaluation. The GOLD ‘ABCD’ groups are now proposed to be derived exclusively from a patient’s symptoms and their history of exacerbations. In the refined assessment scheme, patients should undergo spirometry to determine the severity of airflow limitation. Assessment of either dyspnoea or symptoms, and their history of exacerbations (including prior hospitalisations) should be recorded.
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Strategies for escalation of pharmacological treatments and de-escalation of therapy are included in the report to address the many COPD patients who are already on treatment who return with persistent symptoms after initial therapy, or less commonly with resolution of some symptoms that may subsequently require less therapy.
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Non-pharmacological therapies, including education, pulmonary rehabilitation and exercise training, are comprehensively presented.
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The importance of comorbidities is highlighted, detailing various conditions that must be identified and treated as part of the management of COPD patients.