title: A review of national guidelines for management of COPD in Europe.
abstract: The quality of care can be improved by the development and implementation of evidence-based treatment guidelines. Different national guidelines for chronic obstructive pulmonary disease (COPD) exist in Europe and relevant differences may exist among them.This was an evaluation of COPD treatment guidelines published in Europe and Russia in the past 7 years. Each guideline was reviewed in detail and information about the most important aspects of patient diagnosis, risk stratification and pharmacotherapy was extracted following a standardised process. Guidelines were available from the Czech Republic, England and Wales, Finland, France, Germany, Italy, Poland, Portugal, Russia, Spain and Sweden. The treatment goals, criteria for COPD diagnosis, consideration of comorbidities in treatment selection and support for use of long-acting bronchodilators, were similar across treatment guidelines. There were differences in measures used for stratification of disease severity, consideration of patient phenotypes, criteria for the use of inhaled corticosteroids and recommendations for other medications (e.g. theophylline and mucolytics) in addition to bronchodilators.There is generally good agreement on treatment goals, criteria for diagnosis of COPD and use of long-acting bronchodilators as the cornerstone of treatment among guidelines for COPD management in Europe and Russia. However, there are differences in the definitions of patient subgroups and other recommended treatments.
authors.affiliation: Pneumology Dept, University Hospital Vall d'Hebron, Ciber de Enfermedades Respiratorias (CIBERES), Barcelona, Spain mmiravitlles@vhebron.net.
authors.forename: Marc
authors.initials: M
authors.lastname: Miravitlles
authors.affiliation: Dept of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-University Marburg, German Center for Lung Research (DZL), Marburg, Germany.
authors.forename: Claus
authors.initials: C
authors.lastname: Vogelmeier
authors.affiliation: Service de Pneumologie et Soins Intensifs Respiratoires, Hôpital Cochin, University Paris Descartes (EA2511), Paris, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Roche
authors.affiliation: Royal Devon and Exeter Hospital, Exeter, UK.
authors.forename: David
authors.initials: D
authors.lastname: Halpin
authors.affiliation: Hospital de Santa Marta, Centro Hospitalar de Lisboa Central, Universidade Nova de Lisboa, Lisbon, Portugal.
authors.forename: João
authors.initials: J
authors.lastname: Cardoso
authors.affiliation: Institute of Pulmonology, Federal Medical and Biological Agency, Moscow, Russia.
authors.forename: Alexander G
authors.initials: AG
authors.lastname: Chuchalin
authors.affiliation: Dept of Respiratory Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland Dept of Respiratory Medicine, University of Tampere, Tampere, Finland.
authors.forename: Hannu
authors.initials: H
authors.lastname: Kankaanranta
authors.affiliation: Department of Public Health and Clinical Medicine, Medicine Unit, Umeå University, Umeå, Sweden.
authors.forename: Thomas
authors.initials: T
authors.lastname: Sandström
authors.affiliation: 2nd Department of Respiratory Medicine, Institute of Tuberculosis and Lung Diseases, Warsaw, Poland.
authors.forename: Paweł
authors.initials: P
authors.lastname: Śliwiński
authors.affiliation: Dept of Respiratory Medicine, University Hospital Olomouc, Olomouc, Czech Republic.
authors.forename: Jaromir
authors.initials: J
authors.lastname: Zatloukal
authors.affiliation: Dept of Pathophysiology and Transplantation, Università degli Studi di Milano, IRCCS Fondazione Ospedale Maggiore Policlinico Cà Granda, Milan, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Blasi
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D001993:Bronchodilator Agents / Q000627:therapeutic use*; D018153:Czech Republic; D019468:Disease Management; D004739:England; D005060:Europe; D019317:Evidence-Based Medicine; D005100:Expectorants / Q000627:therapeutic use*; D005387:Finland; D005602:France; D005858:Germany; D006801:Humans; D007558:Italy; D010347:Patient Care Planning; D018579:Patient Selection; D011044:Poland; D011174:Portugal; D017410:Practice Guidelines as Topic; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000188:drug therapy*; D012426:Russia; D013030:Spain; D013548:Sweden; D014852:Wales
chemical_list: D000305:Adrenal Cortex Hormones; D001993:Bronchodilator Agents; D005100:Expectorants