title: Continuing to Confront COPD International Physician Survey: physician knowledge and application of COPD management guidelines in 12 countries.
abstract: OBJECTIVE
  Utilizing data from the Continuing to Confront COPD (chronic obstructive pulmonary disease) International Physician Survey, this study aimed to describe physicians' knowledge and application of the GOLD (Global initiative for chronic Obstructive Lung Disease) Global Strategy for the Diagnosis, Management and Prevention of COPD diagnosis and treatment recommendations and compare performance between primary care physicians (PCPs) and respiratory specialists.
  
  
  METHODS
  Physicians from 12 countries were sampled from in-country professional databases; 1,307 physicians (PCP to respiratory specialist ratio three to one) who regularly consult with COPD, emphysema, or chronic bronchitis patients were interviewed online, by telephone or face to face. Physicians were questioned about COPD risk factors, prognosis, diagnosis, and treatment, including knowledge and application of the GOLD global strategy using patient scenarios.
  
  
  RESULTS
  Physicians reported using spirometry routinely (PCPs 82%, respiratory specialists 100%; P<0.001) to diagnose COPD and frequently included validated patient-reported outcome measures (PCPs 67%, respiratory specialists 81%; P<0.001). Respiratory specialists were more likely than PCPs to report awareness of the GOLD global strategy (93% versus 58%, P<0.001); however, when presented with patient scenarios, they did not always perform better than PCPs with regard to recommending GOLD-concordant treatment options. The proportion of PCPs and respiratory specialists providing first- or second-choice treatment options concordant with GOLD strategy for a GOLD B-type patient was 38% versus 67%, respectively. For GOLD C and D-type patients, the concordant proportions for PCPs and respiratory specialists were 40% versus 38%, and 57% versus 58%, respectively.
  
  
  CONCLUSIONS
  This survey of physicians in 12 countries practicing in the primary care and respiratory specialty settings showed high awareness of COPD-management guidelines. Frequent use of guideline-recommended COPD diagnostic practices was reported; however, gaps in the application of COPD-treatment recommendations were observed, warranting further evaluation to understand potential barriers to adopt guideline recommendations.
authors.affiliation: Worldwide Epidemiology, GlaxoSmithKline, Wavre, Belgium.
authors.forename: Kourtney J
authors.initials: KJ
authors.lastname: Davis
authors.affiliation: Worldwide Epidemiology, GlaxoSmithKline, Uxbridge, UK.
authors.forename: Sarah H
authors.initials: SH
authors.lastname: Landis
authors.affiliation: University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.
authors.forename: Yeon-Mok
authors.initials: YM
authors.lastname: Oh
authors.affiliation: University of Kentucky College of Public Health, Lexington, KY, USA.
authors.forename: David M
authors.initials: DM
authors.lastname: Mannino
authors.affiliation: Division of Pulmonary and Critical Care, University of Michigan, Ann Arbor, MI, USA.
authors.forename: MeiLan K
authors.initials: MK
authors.lastname: Han
authors.affiliation: University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
authors.forename: Thys
authors.initials: T
authors.lastname: van der Molen
authors.affiliation: Pulmonology Research Institute, Moscow, Russia.
authors.forename: Zaurbek
authors.initials: Z
authors.lastname: Aisanov
authors.affiliation: Federal University of Pelotas, Pelotas, Brazil.
authors.forename: Ana M
authors.initials: AM
authors.lastname: Menezes
authors.affiliation: Tohoku University Graduate School of Medicine, Sendai, Japan.
authors.forename: Masakazu
authors.initials: M
authors.lastname: Ichinose
authors.affiliation: Worldwide Epidemiology, GlaxoSmithKline, Wavre, Belgium.
authors.forename: Hana
authors.initials: H
authors.lastname: Muellerova
mesh_terms: D001291:Attitude of Health Personnel; D001364:Awareness; D001938:Brazil; D005060:Europe; D005260:Female; D019983:Guideline Adherence / Q000592:standards / Q000639:trends*; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007564:Japan; D008297:Male; D008800:Mexico; D058007:Physicians, Primary Care / Q000639:trends; D017410:Practice Guidelines as Topic / Q000592:standards; D010818:Practice Patterns, Physicians' / Q000592:standards / Q000639:trends*; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D015272:Pulmonary Medicine / Q000639:trends; D056910:Republic of Korea; D012307:Risk Factors; D013038:Specialization / Q000639:trends; D011795:Surveys and Questionnaires; D014481:United States
keywords: adherence to guidelines; chronic obstructive pulmonary disease; physician beliefs