title: Categorization of COPD patients in Turkey via GOLD 2013 strategy document: ALPHABET study.
abstract: OBJECTIVE
  To determine distribution of COPD assessment categories and physicians' adherence to Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2013 strategy in Turkish COPD patients.
  
  
  METHODS
  A total of 1,610 COPD patients (mean [standard deviation] age: 62.6 [9.9] years, 85.7% were males) were included in this multicenter, non-interventional, cross-sectional study. Patients were categorized via GOLD 2013 strategy document. Consistency between reported and re-classified GOLD categories, and measures used for symptom evaluation and exacerbation was analyzed.
  
  
  RESULTS
  Overall, 41.1% of patients were assigned to GOLD A, while 13.2% were assigned to GOLD C categories. Long-acting beta-2 agonist + long-acting muscarinic antagonist + inhaled corticosteroid regimen was the most common treatment (62.0%). Over-treatment was noted in >70% of GOLD A, B, and C patients. A high consistency between measures of symptom evaluation (Kappa coefficient =0.993, P<0.0001) and a low-moderate consistency between exacerbation risk measures (Kappa coefficient =0.237, P<0.0001) were noted.
  
  
  CONCLUSIONS
  Our findings revealed GOLD A as the most prevalent category in Turkish cohort of COPD patients. Group assignment was altered depending on the chosen measure for symptom and risk assessment. Physician non-adherence to treatment recommendations in GOLD 2013 document leading to over-treatment in patients assigned to GOLD A, B, and C categories was also detected.
authors.affiliation: Department of Chest Diseases, Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey.
authors.forename: Hakan
authors.initials: H
authors.lastname: Gunen
authors.affiliation: Department of Chest Diseases, Safranbolu State Hospital, Karabuk, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Yilmaz
authors.affiliation: Department of Chest Diseases, Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey.
authors.forename: Oguz
authors.initials: O
authors.lastname: Aktas
authors.affiliation: Department of Chest Diseases, Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey.
authors.forename: Pinar
authors.initials: P
authors.lastname: Ergun
authors.affiliation: Department of Chest Diseases, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey.
authors.forename: Mediha Gonenc
authors.initials: MG
authors.lastname: Ortakoylu
authors.affiliation: Department of Chest Diseases, Dr Suat Seren Chest Diseases and Thoracic Surgery Training and Research Hospital, Izmir, Turkey.
authors.forename: Atike
authors.initials: A
authors.lastname: Demir
authors.affiliation: Department of Chest Diseases, Cukurova Dr Askim Tufekci State Hospital, Adana, Turkey.
authors.forename: Pelin
authors.initials: P
authors.lastname: Cetinkaya
authors.affiliation: Department of Chest Diseases, Ege University Faculty of Medicine, Izmir, Turkey.
authors.forename: Alev
authors.initials: A
authors.lastname: Gurgun
authors.affiliation: Department of Chest Diseases, Bingol State Hospital, Bingol, Turkey.
authors.forename: Muge
authors.initials: M
authors.lastname: Otlu
authors.affiliation: Department of Chest Diseases, Akdeniz University, Faculty of Medicine, Antalya, Turkey.
authors.forename: Aykut
authors.initials: A
authors.lastname: Cilli
authors.affiliation: Department of Chest Diseases, Dr Suat Seren Chest Diseases and Thoracic Surgery Training and Research Hospital, Izmir, Turkey.
authors.forename: Ufuk
authors.initials: U
authors.lastname: Yilmaz
authors.affiliation: Department of Chest Diseases, Gazi University Faculty of Medicine, Ankara, Turkey.
authors.forename: Nurdan
authors.initials: N
authors.lastname: Kokturk
authors.affiliation: Department of Chest Diseases, Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey.
authors.forename: Ipek
authors.initials: I
authors.lastname: Candemir
authors.affiliation: Department of Chest Diseases, Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey.
authors.forename: Halil Ibrahim
authors.initials: HI
authors.lastname: Yakar
authors.affiliation: Medical Department, Novartis Pharmaceuticals, Istanbul, Turkey.
authors.forename: Idilhan
authors.initials: I
authors.lastname: Ar
authors.affiliation: Medical Department, Novartis Pharmaceuticals, Istanbul, Turkey.
authors.forename: Aylin
authors.initials: A
authors.lastname: Konya
mesh_terms: D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D058666:Adrenergic beta-2 Receptor Agonists / Q000008:administration & dosage; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001993:Bronchodilator Agents / Q000008:administration & dosage; D003430:Cross-Sectional Studies; D018450:Disease Progression; D004359:Drug Therapy, Combination; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008168:Lung / Q000187:drug effects / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D018727:Muscarinic Antagonists / Q000008:administration & dosage; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000592:standards; D011237:Predictive Value of Tests; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive / Q000145:classification / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology; D020127:Recovery of Function; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014421:Turkey / Q000453:epidemiology
chemical_list: D000305:Adrenal Cortex Hormones; D058666:Adrenergic beta-2 Receptor Agonists; D001993:Bronchodilator Agents; D018727:Muscarinic Antagonists
keywords: Turkey; combined COPD assessment; exacerbation risk; physician adherence; symptoms