WOW February 2017

Page 2 Volume 17; Issue 2
A Summary of the 2017 GOLD Guidelines Update
(continued from page 1)
Addition of hospital discharge and follow-up criteria, including
use of integrated care team
The 2011-2015 versions of the GOLD guidelines provided criteria
for discharge (e.g. ability to use inhaler properly, ability to walk
across room without getting winded, etc.) and recommended follow-up
within four to six weeks (e.g. reassessment of inhaler technique,
status of comorbidities, etc.). 3 The updated guidelines shorten
the recommended follow-up period to 4 weeks, citing a reduced
rate of readmission in patients seen within the shorter timeframe.
1,5 The guidelines also recommend additional follow-up
three months post-discharge to ensure the patient has returned to
stable clinical state. 1 While the guidelines do not mention the value
of a pharmacist specifically, they do encourage the use of coordinated,
integrated care for patients in all settings. Observational
studies in patients with COPD have identified a relationship between
poor inhaler use and symptom control. 6 The updated
GOLD guidelines stress the importance of education and training
in inhaler device technique, and assessment of dosing frequency
and technique at each follow-up visit. 1
References
1. Global Strategy for the Diagnosis, Management and Prevention of
COPD, Global Initiative for Chronic Obstructive Lung Disease
(GOLD) 2017. Available from http://goldcopd.org. Accessed December
2016.
2. Soriano JB, Lamprecht B, Ramirez AS, et al. Mortality prediction in
chronic obstructive pulmonary disease comparing the GOLD 2007
and 2011 staging systems: a pooled analysis of individual patient data.
The Lancet Respiratory Medicine 2015; 3: 443-50.
3. Global Strategy for the Diagnosis, Management and Prevention of
COPD, Global Initiative for Chronic Obstructive Lung Disease
(GOLD) 2016. Available from http://goldcopd.org. Accessed December
2016.
4. Wedzich JA, Banerji D, Chapman KR, et al. Indacaterolglycopyrronium
versus salmeterol-fluticasone for COPD. N Engl J
Med 2016; 374:222-34.
5. Gavish R, Levy A, Dekel OK, et al The Association between hospital
readmission and pulmonologist follow-up visits in patients with
COPD. CHEST 2015; 148:375-81.
6. Melani AS, Bonavia M, Cilenti V, et al. Inhaler mishandling remains
common in real life and is associated with reduced disease control.
Respir Med 2011; 105:930-8.