Update of GOLD Guidelines
The Global Initiative for Chronic Obstructive Lung Disease – known as GOLD – has published its latest guideline for COPD. GOLD has been developing international guidelines for COPD since 1997. An international committee of experts meets regularly to review the latest evidence and update the guideline. The last major re-write of this guideline was in 2011 and there have been four further updates of this guideline since then. See HERE
The Global Initiative for Chronic Obstructive Lung Disease – known as GOLD – has just published its latest guideline for COPD. GOLD has been developing international guidelines for COPD since 1997. An international committee of experts meets regularly to review the latest evidence and update the guideline. The last major re-write of this guideline was in 2011 and there have been four further updates of this guideline since then.
GOLD guideline vs NICE COPD guideline?
While we would normally recommend the NICE COPD guideline over the GOLD guideline, the NICE COPD guideline is somewhat out of date, having not been updated since 2010. NICE undertakes a more comprehensive review of the evidence and prepares their guidance in the context of the English/Welsh NHS. NICE also involves GPs and nurses in developing their guideline. The next review of the NICE guideline is scheduled to start in May, so we cannot expect a revised version until late 2017 or early 2018. Clearly there have been many new treatment options introduced since 2010, which are therefore not covered by NICE currently.
We are aware that local areas developing guidelines may be looking to GOLD as it is more up-to-date than NICE, so we wanted you to be aware of their latest version. See HERE
The GOLD report is presented as a “strategy document” for health care professionals to use as a tool to implement effective management programmes. The ‘quadrant management strategy tool’ is designed to be used in any clinical setting; it draws together a measure of the impact of the patient’s symptoms and an assessment of the patient’s risk of having a serious adverse health event in the future. It also factors in the severity of the spirometric abnormality, and the identification of comorbidities. It then sets out the recommended treatment strategy according to the quadrant a patient falls into.
Many studies have assessed the relevance of this new tool. Evidence will continue to be evaluated by the GOLD committees and management strategy recommendations modified as required.
In 2015, GOLD added a section on Asthma COPD overlap syndrome (ACOS), which does not feature at all in the NICE guideline.
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The Quick Guide to the diagnosis and management of COPD in primary care The PCRS-UK Quick Guide draws on GOLD as well as NICE COPD Guidelines /quality standards and on other relevant national guidance for oxygen, pulmonary rehabilitation and spirometry. Practical and easy to read, it is an excellent, succinct, patient-centred guide to the diagnosis and management of COPD appropriate for the generalist primary care health professional as well as respiratory interested PCRS-UK members. |
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Other useful tools for COPD Table of inhaled drugs from PCRS-UK –updated December 2015 |
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