More than two thirds of PCRS-UK members use the GOLD (Global Initiative for Chronic Obstructive Lung Disease) guideline for the diagnosis, management and prevention of COPD, or a local variation of GOLD, as their management pathway for COPD, according to a survey conducted by PCRS-UK in June.
Only a third (33%) of members continue to use the NICE guideline for the diagnosis and management of COPD.
This is perhaps not surprising given the current NICE guideline (CG101) published in 2010, only includes evidence up to 2009, and does not cover some of the new drug classes which have been introduced since then. The global GOLD guidelines (which are based on a consensus of expert opinion and are pharmaceutical industry funded) are updated more frequently and adopt a different approach to making management decisions
Everyone would agree that the length and complexity of any guideline is daunting and making an informed choice about the best course of action when there are multiple guidelines can be even more difficult for the busy clinician.
‘Treatment guidelines for COPD – going for GOLD?’ is a consensus based article that sets out a simple treatment pathway based on the predominant characteristics of COPD for an individual – whether symptoms or exacerbations - distilled from current guidelines.
The article has been developed by a group of clinicians working with and in primary care, facilitated by integrated care consultant, Vince Mak, Kevin Gruffydd-Jones GP and RCGP clinical lead for respiratory care, Duncan Keeley, GP and PCRS-UK Executive policy lead, and, Carol Stonham, primary care respiratory nurse and PCRS-UK vice chair.
Why this article is helpful
Carol Stonham says: "Understanding how and why there is a difference between NICE and the recent GOLD guidelines will give clinicians a clearer grasp on treatment options for patients with COPD, and the treatment pathway will simplify prescribing decisions improving safer patient care."
Duncan Keeley says: ‘This article describes and assesses the similarities and differences between the two guidelines and suggests a practical approach to making management decisions in primary care. Do read this article to see whether you find it helpful - we think you will.’
You can download the article HERE