Adherence to Current COPD Guidelines in Turkey.

Area of Science:

• Pulmonology
• Respiratory Medicine
• Clinical Practice Guidelines

Background:

• International and national guidelines exist for chronic obstructive pulmonary diseases (COPD) management.
• However, adherence to these COPD treatment recommendations in clinical practice is often suboptimal.

Purpose of the Study:

• To evaluate the appropriateness of COPD patient treatment in Turkey based on current guidelines.
• To identify specific areas of non-adherence and potential for improvement in COPD care.

Main Methods:

• A cross-sectional study involving 307 COPD outpatients across six chest disease clinics.
• Patients were classified using spirometry classification (SC) and combined classification (CC).
• Treatment protocols were assessed for suitability against both SC and CC criteria.

Main Results:

• 40.4% of treatments were suitable for both SC and CC; 30.9% for CC, and 20.8% for SC.
• 51.8% of patients received unsuitable therapy for SC, and 38.4% for CC.
• Overtreatment, primarily with inhaled corticosteroids (ICS) (58% of patients used LABA + LAMA + ICS), constituted 98% of inappropriate treatments, with improper ICS usage high in both classifications (97.1% CC, 93.1% SC).

Conclusions:

• Overtreatment, particularly with ICS, is the most frequent form of inappropriate COPD management.
• Low adherence to evolving COPD guidelines persists in clinical practice.
• Enhanced awareness and education on COPD guidelines for pulmonary specialists are crucial.