Summarizing the 2021 Updated GOLD Guideline for COPD

Mackenzie Laisure, PharmD Candidate 2022; Nicole Covill, PharmD Candidate 2022; Marissa L. Ostroff, PharmD, BCPS, BCGP; Jared L. Ostroff, PharmD, MBA, BCACP, BCGP

Disclosures

US Pharmacist. 2021;46(7):30-36. 

In This Article

Abstract and Introduction

Abstract

Chronic obstructive pulmonary disease (COPD) is a complex disease that requires differential diagnosis and proper classification to identify appropriate therapy. Nonpharmacologic therapy and preventative measures should be utilized to prevent worsening of disease, symptoms, and complications. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines classify a patient's COPD and provide recommendations for first-line treatment. The 2021 update included information regarding the use of e-cigarettes as nicotine replacement, triple therapy, and how the SARS-CoV-2 virus impacted patients with COPD. This article will focus on the diagnosis, classification, and treatment of COPD, as well as recently updated information regarding the use of e-cigarettes and the impact of COVID-19.

Introduction

Chronic obstructive pulmonary disease (COPD) is a common, preventable, and treatable disease characterized by persistent respiratory symptoms and limitations to airflow due to abnormalities within the airway and/or alveolar. Common symptoms of COPD include chronic or progressive dyspnea, cough with sputum production, and recurrent lower respiratory tract infections. A patient may be at an increased risk for COPD due to exposure to noxious particles via cigarette smoking, occupational exposures, or air pollution, as well as due to genetics, socioeconomic status, airway hyperreactivity, and other factors.

Pharmacologic and nonpharmacologic therapy for the management of COPD is used to reduce the frequency and severity of symptoms and exacerbations, increase exercise tolerance, and improve overall quality of life. Smoking cessation is important in preventing progression of COPD and is an area where pharmacists can assist. A proper treatment regimen is determined based on severity of airflow limitation, symptom burden, and risk of exacerbation, as defined in the GOLD guidelines.

The SARS-CoV-2 virus has posed unique obstacles to the diagnosis and management of COPD. This may include difficulties differentiating between COVID-19 infection and COPD, increased use of telemedicine, inability to properly assess inhaler technique, infection risks of using certain inhaler types, and increased risk of severe complications. This review will summarize the updated 2021 GOLD guidelines for the diagnosis, management, and prevention of COPD.[1]

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