Adherence to GOLD Recommendations among Swiss Pulmonologists and General Practitioners

Area of Science:

• Pulmonology
• Pharmacotherapy
• Clinical Practice Guidelines

Background:

• Adherence to COPD management recommendations shows significant variability.
• Real-world prescribing patterns for COPD pharmacotherapy require evaluation.

Purpose of the Study:

• To assess real-life COPD pharmacotherapy prescribing patterns.
• To evaluate adherence to the 2017 Global Initiative for Chronic Obstructive Lung Disease (GOLD) strategy in Switzerland.

Main Methods:

• A questionnaire-based survey was conducted among Swiss general practitioners (GPs) and pulmonologists (PULs).
• Data were collected on 511 COPD patients regarding their pharmacological treatment, dyspnea (mMRC scale), and exacerbation history.
• Prescriptions were analyzed for concordance with GOLD 2017 recommendations.

Main Results:

• 62.5% of patients reported dyspnea (mMRC grade ≥2); 31.9% had ≥2 exacerbations or ≥1 hospitalization in the past year.
• Overtreatment was frequent across GOLD stages: 87.1% in GOLD A, 37% in GOLD B, and 47.5% in GOLD C.
• Adherence varied: 52.2% in GOLD B, 49.2% in GOLD C, and 78.8% in GOLD D were treated according to recommendations, with 15.2% undertreated in GOLD D.
• Treatment was modified in 50.3% of patients after reassessment.

Conclusions:

• Real-world COPD prescription patterns frequently discord with international guidance.
• Significant overtreatment and undertreatment exist, indicating suboptimal adherence to GOLD recommendations.
• Further educational initiatives are necessary to enhance adherence to COPD management guidelines.