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  1. NTU Scholars
  2. 醫學院
  3. 醫學系
Please use this identifier to cite or link to this item: https://scholars.lib.ntu.edu.tw/handle/123456789/530829
Title: The impact of 2011 and 2017 Global Initiative for Chronic Obstructive Pulmonary Disease (GOLD) guidelines on allocation and pharmacological management of patients with COPD in Taiwan: Taiwan Obstructive Lung Disease (TOLD) study
Authors: Hsieh M.-J.
Huang S.-Y.
Yang T.-M.
Tao C.-W.
Cheng S.-L.
Lee C.-H.
PING-HUNG KUO 
Wu Y.-K.
Chen N.-H.
Hsu W.-H.
Hsu J.-Y.
Lin M.-S.
Wang C.-C.
Wei Y.-F.
Tsai Y.-H.
Keywords: Chronic obstructive pulmonary disease; Gold guidelines; Inhaled corticosteroids; Long-acting bronchodilators
Issue Date: 2018
Publisher: Dove Medical Press Ltd.
Journal Volume: 13
Start page/Pages: 2949-2959
Source: International Journal of COPD
Abstract: 
Background: This nationwide study was performed to evaluate the evolution of distributions of patients with COPD according to the 2011 and 2017 Global Initiative for Chronic Obstructive Pulmonary Disease (GOLD) guidelines and to assess the concordance between the prescribed medications and the pharmacological management recommended by the two distinct classification systems in Taiwan. Subjects and methods: Data were retrospectively retrieved from stable COPD patients in 11 participating hospitals across Taiwan. Patients were grouped according to GOLD 2011 and 2017 guidelines respectively. Definitions of undertreatment and overtreatment were based on the pharmacological recommendations in the individual guidelines. Results: A total of 1,053 COPD patients were included. The percentages of patients in GOLD 2011 groups A, B, C and D were 18.4%, 40.6%, 6.7% and 34.2%, respectively. When reclassified according to the GOLD 2017, the percentages of group A and B increased to 23.3% and 63.2%, and groups C and D decreased to 1.9% and 11.6%, respectively. Up to 67% of patients in GOLD 2011 groups C and D were reclassified to GOLD 2017 groups A and B. The pharmacological concordance rate was 60.9% for GOLD 2011 and decreased to 44.9% for GOLD 2017. Overtreatment was found in 29.5% of patients according to GOLD 2011 and the rate increased to 46.1% when classified by the GOLD 2017. The major cause of overtreatment was unnecessary inhaled corticosteroids and the main cause of undertreatment was a lack of maintenance long-acting bronchodilators. Conclusion: The distribution of COPD patients in Taiwan was more uneven with the GOLD 2017 than with the GOLD 2011. A pharmacological discordance to the guidelines was identified. Updated guidelines with reclassification of COPD patients resulted in more discordance between prescribed medications and the guidelines. Physicians should make proper adjustments of the prescriptions according to the updated guidelines to ensure the mostly appropriate treatment for COPD patients. ? 2018 Hsieh et al.
URI: https://www.scopus.com/inward/record.uri?eid=2-s2.0-85054779927&doi=10.2147%2fCOPD.S176065&partnerID=40&md5=e3a55fe7b31032ce463c0bbecb459548
https://scholars.lib.ntu.edu.tw/handle/123456789/530829
ISSN: 1176-9106
DOI: 10.2147/COPD.S176065
SDG/Keyword: aminophylline; beta adrenergic receptor stimulating agent; corticosteroid; muscarinic receptor blocking agent; phosphodiesterase IV inhibitor; theophylline; bronchodilating agent; corticosteroid; aged; Article; chronic obstructive lung disease; disease exacerbation; drug choice; female; high risk patient; human; low risk patient; major clinical study; male; observational study; practice guideline; protocol compliance; retrospective study; secondary care center; Taiwan; teaching hospital; chronic obstructive lung disease; global health; inhalational drug administration; middle aged; outcome assessment; severity of illness index; statistics and numerical data; Administration, Inhalation; Adrenal Cortex Hormones; Aged; Bronchodilator Agents; Female; Global Health; Guideline Adherence; Humans; Male; Middle Aged; Outcome Assessment (Health Care); Practice Guidelines as Topic; Pulmonary Disease, Chronic Obstructive; Retrospective Studies; Severity of Illness Index; Taiwan
[SDGs]SDG3
Appears in Collections:醫學系

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臺大位居世界頂尖大學之列,為永久珍藏及向國際展現本校豐碩的研究成果及學術能量,圖書館整合機構典藏(NTUR)與學術庫(AH)不同功能平台,成為臺大學術典藏NTU scholars。期能整合研究能量、促進交流合作、保存學術產出、推廣研究成果。

To permanently archive and promote researcher profiles and scholarly works, Library integrates the services of “NTU Repository” with “Academic Hub” to form NTU Scholars.

總館學科館員 (Main Library)
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開放取用是從使用者角度提升資訊取用性的社會運動,應用在學術研究上是透過將研究著作公開供使用者自由取閱,以促進學術傳播及因應期刊訂購費用逐年攀升。同時可加速研究發展、提升研究影響力,NTU Scholars即為本校的開放取用典藏(OA Archive)平台。(點選深入了解OA)

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