[Risks, phenotypes and comparison between treatments according to guidelines GOLD and GesEPOC in primary care]

Chronic obstructive pulmonary disease (COPD) is an underdiagnosed pathology with a high morbidity and mortality. Diagnosis and follow-up are mostly carried out in primary care (PC). The objective of our study is to classify COPD patients according to GOLD 2019 and GesEPOC 2017 guidelines. As secondary objectives, to analyze the type of risk and to describe and compare the prescribed treatment with that recommended by the guidelines.

Multicenter cross-sectional observational study in seven Health Care centers. 637 COPD patients between 35 and 85years old were included.

The mean age was 70.3years old, 84.6% had comorbidities and 43.5% were active smokers. The mean post-bronchodilator FEV₁ was 61.92% (SD: 17.42). Most are patients with mMRC=1 (43.8%), 57.8% CAT<10. Mild BODEx index (75.7%). GoldA was the majority (47.7%). The most frequent phenotype was non-exacerbator (61.1%). 25% were ACOs. 56.2% were low-risk patients. 20.6% had not been prescribed any treatment, LABA +LAMA +CI (19.6%), LAMA +LABA (16.5%) and LAMA (16.3%). If we compare the treatments that the patients have prescribed, with the one is recommended by GOLD, we obtain that 61% coincide with moderate concordance, while if we compare with GesEPOC, 53.8% coincide with weak concordance. 73.4% of the treatments coincide between both documents (moderate agreement).

COPD patients treated in PC are low risk, mild and non-exacerbators. If we compare the treatments that the patients have prescribed, with what is recommended by GOLD and GesEPOC, we find a moderate and weak concordance, respectively.