Updated 2017 GOLD Recommendations for COPD
Important revisions to the GOLD recommendations include a new definition of COPD and refined diagnostic categories.
New Definition for COPD. Emphasizes respiratory symptoms and lung tissue and airway abnormalities in COPD development.
Assessment Criteria Refined. Assessment refined to separate spirometric from comprehensive symptom evaluation; spirometry required for diagnosis.
New Diagnostic Subgroups.Traditional “ABCD” disease severity groups (based on respiratory symptoms and exacerbation history) are further defined by addition of spirometric grade subgroups
Pharmacotherapy, Treatment Intensification.Treatment of stable COPD now based on disease impact (symptom burden, activity limitations) and risk of progression as determined by exacerbations.
Recommendations for Nonpharmacologic Therapies. Stresses personalized approach according to ABCD groups; covers education and self-management, physical activity, pulmonary rehab, exercise training, palliative care, more.
Use Standard of Care for Comorbidities. Treat comorbidities according to standard of care per disease, despite COPD; focus on CVD, osteoporosis, anxiety, depression, lung cancer, infection, more.
Take-home Points.Guideline revision gives new definition of COPD; separates spirometric and comprehensive symptom evaluation; new subgroups indicate spirometric grade; treat exacerbations per ABCD group; focus on nondrug therapies, aggressively manage comorbidities.
In February 2017 the Global Initiative for Chronic Obstructive Lung Disease (GOLD) issued updated recommendations for the diagnosis, management and prevention of COPD1,2The slide show above summarizes the major changes to the guidelines which focus on:⺠COPD assessment⺠New COPD diagnostic subgroups⺠Therapy escalation strategies⺠Nonpharmacologic therapies⺠Comorbid conditions Logo is a trademark of the Global Initiative for Chronic Obstructive Lung Disease.
