Categorization of COPD patients in Turkey via GOLD 2013 strategy document: ALPHABET study

Int J Chron Obstruct Pulmon Dis. 2015 Nov 13:10:2485-94. doi: 10.2147/COPD.S87464. eCollection 2015.

Abstract

Objective: To determine distribution of COPD assessment categories and physicians' adherence to Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2013 strategy in Turkish COPD patients.

Methods: A total of 1,610 COPD patients (mean [standard deviation] age: 62.6 [9.9] years, 85.7% were males) were included in this multicenter, non-interventional, cross-sectional study. Patients were categorized via GOLD 2013 strategy document. Consistency between reported and re-classified GOLD categories, and measures used for symptom evaluation and exacerbation was analyzed.

Results: Overall, 41.1% of patients were assigned to GOLD A, while 13.2% were assigned to GOLD C categories. Long-acting beta-2 agonist + long-acting muscarinic antagonist + inhaled corticosteroid regimen was the most common treatment (62.0%). Over-treatment was noted in >70% of GOLD A, B, and C patients. A high consistency between measures of symptom evaluation (Kappa coefficient =0.993, P<0.0001) and a low-moderate consistency between exacerbation risk measures (Kappa coefficient =0.237, P<0.0001) were noted.

Conclusion: Our findings revealed GOLD A as the most prevalent category in Turkish cohort of COPD patients. Group assignment was altered depending on the chosen measure for symptom and risk assessment. Physician non-adherence to treatment recommendations in GOLD 2013 document leading to over-treatment in patients assigned to GOLD A, B, and C categories was also detected.

Keywords: Turkey; combined COPD assessment; exacerbation risk; physician adherence; symptoms.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Inhalation
  • Adrenal Cortex Hormones / administration & dosage
  • Adrenergic beta-2 Receptor Agonists / administration & dosage
  • Adult
  • Aged
  • Aged, 80 and over
  • Bronchodilator Agents / administration & dosage
  • Cross-Sectional Studies
  • Disease Progression
  • Drug Therapy, Combination
  • Female
  • Guideline Adherence
  • Humans
  • Lung / drug effects
  • Lung / physiopathology*
  • Male
  • Middle Aged
  • Muscarinic Antagonists / administration & dosage
  • Practice Guidelines as Topic
  • Practice Patterns, Physicians'* / standards
  • Predictive Value of Tests
  • Prevalence
  • Pulmonary Disease, Chronic Obstructive / classification
  • Pulmonary Disease, Chronic Obstructive / diagnosis*
  • Pulmonary Disease, Chronic Obstructive / drug therapy
  • Pulmonary Disease, Chronic Obstructive / epidemiology
  • Pulmonary Disease, Chronic Obstructive / physiopathology
  • Recovery of Function
  • Severity of Illness Index
  • Treatment Outcome
  • Turkey / epidemiology

Substances

  • Adrenal Cortex Hormones
  • Adrenergic beta-2 Receptor Agonists
  • Bronchodilator Agents
  • Muscarinic Antagonists