Recommendations for COPD management in Central and Eastern Europe

Area of Science:

• Pulmonology and Respiratory Medicine
• Public Health
• Clinical Practice Guidelines

Background:

• Chronic Obstructive Pulmonary Disease (COPD) management guidelines, like the GOLD strategy, require adaptation due to global variations in disease characteristics and healthcare systems.
• Heterogeneity in COPD prevalence, disease progression, and phenotype distribution necessitates region-specific approaches.
• Significant differences exist in clinical practices and healthcare systems for COPD patients even within similar economic and geographic regions.

Purpose of the Study:

• To offer region-specific insights for managing COPD in Central and Eastern Europe (CEE).
• To adapt the GOLD 2022 report recommendations into national clinical guidelines tailored for the CEE region.
• To provide practical guidance for optimizing COPD management considering unique regional factors.

Main Methods:

• A workshop with respiratory physicians from eleven CEE countries was conducted in December 2018.
• Subsequent discussions and analysis of regional clinical practices and healthcare systems were performed.
• Recommendations from the GOLD 2022 report were reviewed for adaptation to the CEE context.

Main Results:

• Identified key factors influencing COPD management in CEE, including smoking status, vaccination rates, and prevalence of tuberculosis and nontuberculous mycobacteria.
• Developed region-specific guidance and algorithms for pharmacologic and non-pharmacologic COPD management.
• Provided strategies for initial/follow-up treatment, managing frequent exacerbations, and inhaled corticosteroid withdrawal.

Conclusions:

• COPD management strategies must account for regional differences in disease characteristics and healthcare systems.
• Tailored national clinical guidelines are essential for effective COPD care in CEE.
• The proposed guidance supports optimizing COPD treatment pathways in Central and Eastern Europe.