title: Adherence to the Global Initiative for Chronic Obstructive Lung Disease guidelines for management of COPD: a hospital-base study.
abstract: OBJECTIVE
  To determine the level of adherence to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines, we compared our inpatient management of exacerbations of chronic obstructive pulmonary disease (COPD) to these guidelines.
  
  
  METHODS
  This cross-sectional descriptive study was conducted from January 2011 to April 2012 in a 360-bed teaching hospital in Shiraz, Iran. We recorded the management data for 96 consecutive patients with COPD exacerbation. SPSS 11.5 software (SPSS Inc., Chicago, IL, USA) was used for all statistical analyses.
  
  
  RESULTS
  The mean (standard deviation) age of our patients was 67.3 (14) years, and more than 75% of them were men. Adherence for starting antibiotics was 84.4%. Most of our patients (82.3%) received oxygen therapy, for a level of adherence to GOLD recommendations of 74%. Nearly 95% received a short-acting bronchodilator, and 12.5% received a long-acting bronchodilator. Adherence to the guidelines was 19.8% for oral and 61.4% for inhaled steroids. Adherence to the guidelines was 49% for starting N-acetylcysteine, 77.1% for antitussives and 13.5% for xanthine derivatives (aminophylline and theophylline). The overall adherence to GOLD guidelines was 67.2% at our hospital.
  
  
  CONCLUSIONS
  The level of adherence to GOLD guidelines for the management of COPD exacerbation was suboptimal at our teaching hospital. Further improvements in adherence to these guidelines are needed.
authors.affiliation: Internal Medicine Department, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Seyed Masoom
authors.initials: SM
authors.lastname: Masoompour
authors.affiliation: Student Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Abbas
authors.initials: A
authors.lastname: Mohammadi
authors.affiliation: Social Determinants of Health Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Hamideh
authors.initials: H
authors.lastname: Mahdaviazad
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D019468:Disease Management; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D007492:Iran; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D029424:Pulmonary Disease, Chronic Obstructive / Q000628:therapy*
keywords: chronic obstructive pulmonary disease; clinical guidelines; evaluation; exacerbation; management