Adherence to Pharmacological Management Guidelines for Stable COPD.

Abstract

Background: This study has evaluated the adherence to the Global initiative for chronic Obstructive Lung Disease (GOLD) and Korean guidelines in prescription pattern of respiratory specialists for stable COPD management.

Methods: We collected data on medications between 2011 and 2022 using the Korea COPD Subtype Study (KOCOSS) cohort. Patients were divided into two groups, patients registered before and after 2019, and we analyzed the percentage of patients who met the appropriate criteria for treatment recommended by each of guidelines.

Results: Among 3,477 patients, 85.6% were treated with any drug, and 81.6% used inhaled medications. Compared to patients registered before 2019, there was an increase in inhaler prescriptions in patients registered after 2019 (79.7% and 86.7%, respectively), with dual bronchodilators being the most frequently prescribed medication. Of the treated patients, 56.9% aligned with the Korean 2018 guideline. Based on the criteria from the GOLD 2019 and 2023 guidelines, appropriate treatments were observed in 31.3% and 28.0% of cases. When considering the prescription of inhalers in both subgroups and applying the Korean 2018, GOLD 2019, and GOLD 2023 guidelines, the adherence rates were as follows: (56.6%, 37.8%, 24.0%) and (57.7%, 14.0%, 38.6%).

Conclusions: The adherence rate was higher to the Korean guideline compared to GOLD recommendation. In addition, the proportion of patients aligning with the Korean 2018 and GOLD 2023 guidelines increased in the patients enrolled after 2019 compared to those enrolled earlier. These results suggest that physicians adapt their treatment approaches in alignment with the domestic or recent international guidelines.