在COPD患者中遵守吸入药物指南:在现实中等护理环境中评估GOLD 2023战略
Liz J A Cuperus1,2,3, Gina De Jong4, Erik W M A Bischoff5
1Pulmonology Department, Franciscus Gasthuis and Vlietland, Rotterdam, the Netherlands.
International journal of chronic obstructive pulmonary disease
|December 8, 2025
概括
医生经常不遵循全球慢性阻塞性肺病倡议 (GOLD) 对吸入药物的指导方针. 2023年更新显示有轻微改善,但在COPD管理中,吸入性皮质类固醇 (ICS) 的过度治疗仍然很常见.
科学领域:
- 肺部病理学 肺部病理学
- 临床实践指南 临床实践指南
- 药物治疗 药物治疗
背景情况:
- 2023年全球慢性阻塞性肺病倡议 (GOLD) 战略更新了吸入药物推,限制长效β-激动剂/吸入皮质类固醇 (LABA/ICS) 的使用,并强调ICS对恶化.
- 这些变化需要在现实环境中评估临床医生的遵守和处方模式.
研究的目的:
- 评估在慢性阻塞性肺病 (COPD) 队列中对吸入疗法的2023年GOLD战略的遵守情况.
- 为了确定2023年GOLD战略更新后处方模式的变化.
- 调查吸入性皮质类固醇 (ICS) 使用的患病率和症状.
主要方法:
- 在2022年在荷兰一家教学医院评估了COPD患者的真实世界队列,并在2023年重新评估.
- 通过将患者的处方与每年适用的GOLD策略进行比较来确定治疗坚持.
- 特别关注的是ICS处方模式及其与指南标准的协调.
主要成果:
- 准则遵守率略有增加,从2022年的51.6%增加到2023年的57.3%.
- 患有低乙氨基细胞,没有恶化或不太严重的COPD的患者在2023年接受符合指南的治疗的可能性较低.
- ICS的过度治疗很普遍,影响了25.4%的患者.
结论:
- 很大一部分COPD患者没有按照目前的GOLD建议进行治疗,这表明指南与实践之间存在差距.
- 虽然可能存在偏差的原因,但医生应该批判性地评估治疗的最佳性,特别是关于ICS使用.
- 实施GOLD战略的障碍需要识别和讨论,以改善COPD管理.
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