Adherence to Global Initiative for Chronic Obstructive Lung Disease guidelines in the real world: current...

Area of Science:

• Pulmonology
• Clinical Practice Guidelines
• Healthcare Management

Background:

• The Global Initiative for Chronic Obstructive Lung Disease (GOLD) provides essential guidance for COPD management.
• Adherence to GOLD guidelines in clinical practice remains a significant challenge.
• Understanding barriers to guideline adoption is crucial for improving patient outcomes.

Purpose of the Study:

• To review the literature on reasons for suboptimal adherence to GOLD guidelines.
• To identify key barriers hindering the implementation of COPD management strategies.
• To inform strategies for enhancing clinician adoption of evidence-based COPD care.

Main Methods:

• Systematic literature review.
• Analysis of studies reporting on barriers to GOLD guideline implementation.
• Synthesis of identified challenges in clinical practice.

Main Results:

• Key barriers include delayed or missed COPD diagnosis due to lack of awareness, limited spirometry use, and inadequate symptom assessment.
• Improper pharmacotherapy selection, misclassification of COPD phenotypes, and insufficient smoking cessation and pulmonary rehabilitation support are also prevalent.
• Lack of awareness, limited spirometry, and poor phenotyping contribute to suboptimal COPD management.

Conclusions:

• Multiple barriers impede the routine clinical adoption of GOLD guidelines for COPD.
• Systematic solutions, including clinical decision support, self-care models, and improved phenotyping, can enhance guideline adherence.
• Targeted interventions are needed to overcome these barriers and improve COPD patient care.