Categorization of COPD patients in Turkey via GOLD 2013 strategy document: ALPHABET study.
Categorization of COPD patients in Turkey via GOLD 2013 strategy document: ALPHABET study.
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DOI：
10.2147/copd.s87464
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发表时间：
2015
影响因子：
2.8
通讯作者：
Konya A
中科院分区：
文献类型：
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作者：
Gunen H;Yilmaz M;Aktas O;Ergun P;Ortakoylu MG;Demir A;Cetinkaya P;Gurgun A;Otlu M;Cilli A;Yilmaz U;Kokturk N;Candemir I;Yakar HI;Ar I;Konya A
旨在确定土耳其 COPD 患者中 COPD 评估类别的分布以及医生对慢性阻塞性肺病全球倡议 (GOLD) 2013 年策略的遵守情况。这项多中心、非干预性横断面研究共纳入 1,610 名 COPD 患者（平均[标准差]年龄：62.6[9.9]岁，85.7% 为男性）。根据 GOLD 2013 战略文件对患者进行分类。分析了报告和重新分类的 GOLD 类别以及用于症状评估和恶化的措施之间的一致性。总体而言，41.1% 的患者被分配到 GOLD A 类别，而 13.2% 的患者被分配到 GOLD C 类别。长效β2激动剂+长效毒蕈碱拮抗剂+吸入皮质类固醇方案是最常见的治疗方案（62.0%）。超过 70% 的 GOLD A、B 和 C 级患者出现过度治疗。症状评估指标之间具有高度一致性（Kappa 系数=0.993，P<0.0001），而恶化风险指标之间具有低-中等一致性（Kappa 系数=0.237，P<0.0001）。我们的研究结果显示，GOLD A 是土耳其 COPD 患者队列中最常见的类别。根据所选的症状和风险评估措施来改变小组分配。还发现医生不遵守 GOLD 2013 文件中的治疗建议，导致分配到 GOLD A、B 和 C 类别的患者过度治疗。
To determine distribution of COPD assessment categories and physicians’ adherence to Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2013 strategy in Turkish COPD patients. A total of 1,610 COPD patients (mean [standard deviation] age: 62.6 [9.9] years, 85.7% were males) were included in this multicenter, non-interventional, cross-sectional study. Patients were categorized via GOLD 2013 strategy document. Consistency between reported and re-classified GOLD categories, and measures used for symptom evaluation and exacerbation was analyzed. Overall, 41.1% of patients were assigned to GOLD A, while 13.2% were assigned to GOLD C categories. Long-acting beta-2 agonist + long-acting muscarinic antagonist + inhaled corticosteroid regimen was the most common treatment (62.0%). Over-treatment was noted in >70% of GOLD A, B, and C patients. A high consistency between measures of symptom evaluation (Kappa coefficient =0.993, P<0.0001) and a low-moderate consistency between exacerbation risk measures (Kappa coefficient =0.237, P<0.0001) were noted. Our findings revealed GOLD A as the most prevalent category in Turkish cohort of COPD patients. Group assignment was altered depending on the chosen measure for symptom and risk assessment. Physician non-adherence to treatment recommendations in GOLD 2013 document leading to over-treatment in patients assigned to GOLD A, B, and C categories was also detected.