PDF(Sci-hub)
Abstract：
The guidelines for chronic obstructive pulmonary disease (COPD) treatment are important for the management of the disease. However, studies regarding the treatment adherence to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines have been scarce in Korea. Therefore, to examine the adherence to the GOLD guidelines, we examined the patterns of prescribed medication in COPD patients from 2011 to 2018. Patients were classified as having been appropriately and inappropriately treated (overtreatment or undertreatment) for the GOLD group. Appropriate medical therapy was defined as using the first choice or alternative choice drug recommended in the GOLD guidelines. Inappropriate therapy was classified as overtreatment or undertreatment in accordance with the categorization in the GOLD guidelines. According to treatment of 2011 GOLD guidelines, there was inappropriate treatment in 52.3% in group A, 47.3% in group B, 56.3% in group C, and 17.8% in group D. According to treatment of 2017 GOLD guidelines, there was inappropriate treatment in 66.7% in group A, 45.3% in group B, 14.3% in group C, and 24.0% in group D. The common type of inappropriate COPD treatment is overtreatment, with inhaled corticosteroid (ICS) containing regimens. In conclusions, adherence to the GOLD guideline by the pulmonologist in clinical practice is still low in Korea. Therefore, we need better strategies to both optimize the use of the guidelines and adhere to the guidelines as well.
摘要：
慢性阻塞性肺疾病（COPD）治疗指南对于该疾病的管理很重要。然而,在韩国,有关全球慢性阻塞性肺疾病倡议(GOLD)指南的治疗依从性的研究很少.因此,为了检查对黄金准则的遵守情况，我们调查了2011年至2018年COPD患者的处方用药模式.对于GOLD组，患者被分类为接受了适当和不适当的治疗（过度治疗或治疗不足）。适当的药物治疗定义为使用GOLD指南中推荐的首选或替代选择药物。根据GOLD指南的分类，将不适当的治疗分为过度治疗或治疗不足。根据2011年GOLD治疗指南，A组有52.3%的患者治疗不当,B组47.3%,C组56.3%,D组为17.8%。根据2017年GOLD指南的治疗，A组有66.7%的患者治疗不当,B组45.3%,C组14.3%,D组为24.0%。不适当的COPD治疗的常见类型是过度治疗，含吸入皮质类固醇（ICS）的方案。在结论中，在韩国，肺科医师在临床实践中对GOLD指南的依从性仍然很低。因此,我们需要更好的策略来优化指南的使用并遵守指南。
