https://scholars.lib.ntu.edu.tw/handle/123456789/530829
DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor.author | Hsieh M.-J. | en_US |
dc.contributor.author | Huang S.-Y. | en_US |
dc.contributor.author | Yang T.-M. | en_US |
dc.contributor.author | Tao C.-W. | en_US |
dc.contributor.author | Cheng S.-L. | en_US |
dc.contributor.author | Lee C.-H. | en_US |
dc.contributor.author | PING-HUNG KUO | en_US |
dc.contributor.author | Wu Y.-K. | en_US |
dc.contributor.author | Chen N.-H. | en_US |
dc.contributor.author | Hsu W.-H. | en_US |
dc.contributor.author | Hsu J.-Y. | en_US |
dc.contributor.author | Lin M.-S. | en_US |
dc.contributor.author | Wang C.-C. | en_US |
dc.contributor.author | Wei Y.-F. | en_US |
dc.contributor.author | Tsai Y.-H. | en_US |
dc.date.accessioned | 2020-12-23T06:26:29Z | - |
dc.date.available | 2020-12-23T06:26:29Z | - |
dc.date.issued | 2018 | - |
dc.identifier.issn | 1176-9106 | - |
dc.identifier.uri | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85054779927&doi=10.2147%2fCOPD.S176065&partnerID=40&md5=e3a55fe7b31032ce463c0bbecb459548 | - |
dc.identifier.uri | https://scholars.lib.ntu.edu.tw/handle/123456789/530829 | - |
dc.description.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. | - |
dc.publisher | Dove Medical Press Ltd. | - |
dc.relation.ispartof | International Journal of COPD | - |
dc.subject | Chronic obstructive pulmonary disease; Gold guidelines; Inhaled corticosteroids; Long-acting bronchodilators | - |
dc.subject.classification | [SDGs]SDG3 | - |
dc.subject.other | 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 | - |
dc.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 | en_US |
dc.type | journal article | en |
dc.identifier.doi | 10.2147/COPD.S176065 | - |
dc.identifier.pmid | 30310271 | - |
dc.identifier.scopus | 2-s2.0-85054779927 | - |
dc.relation.pages | 2949-2959 | - |
dc.relation.journalvolume | 13 | - |
item.cerifentitytype | Publications | - |
item.grantfulltext | none | - |
item.fulltext | no fulltext | - |
item.openairecristype | http://purl.org/coar/resource_type/c_6501 | - |
item.openairetype | journal article | - |
crisitem.author.dept | Internal Medicine-NTUH | - |
crisitem.author.orcid | 0000-0003-3756-3395 | - |
crisitem.author.parentorg | National Taiwan University Hospital | - |
顯示於: | 醫學系 |
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