Application of GOLD 2023 Initial Inhalation Therapy Recommendations in COPD patients: a real-world adherence and prognosis analysis PDF Free Download
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Electronic supplementary material:
The online version of this article contains supplementary material.
Cite as: Deng D, Peng D, Song Q, Lin L, Liu C, Li T, Zhang P, Zeng Y, Lei S, Chen P. Application
of GOLD 2023 Initial Inhalation Therapy Recommendations in COPD patients: a real-world
adherence and prognosis analysis. J Glob Health. 2025;14:04324.
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Correspondence to:
Background The Global Initiative for Chronic Obstructive Lung Disease
(GOLD) 2023 report revised the combined chronic obstructive pulmo-
nary disease (COPD) assessment. Patients were classified into groups
A, B, and E, and the initial inhalation therapy recommendations were
revised. This study aimed to investigate the application status of initial
inhalation therapy recommendations in patients with COPD and deter-
mine whether adherence to the GOLD 2023 report could achieve a bet-
ter prognosis.
Methods This was a prospective cohort study. Demographic data, COPD
assessment test (CAT) and modified Medical Research Council (mMRC)
scores, pulmonary function, GOLD grades, GOLD groups, number of
exacerbations, comorbidities, and inhalation therapy were collected.
The patients were classified into adherent and non-adherent groups
based on the provision of initial inhalation therapy recommendations
that aligned with the GOLD A, B, and E groupings. All patients finished
one year of follow-up to collect data on the number of exacerbations
and mortality.
Results A total of 1654 patients were enrolled, of whom 816 (49.3%) were
in the adherent group. The patients in the adherent group had higher
age, CAT and mMRC scores, and number of exacerbations and hospital-
isations, higher proportion of combined with lung cancer and chronic
heart disease, and worse pulmonary function. Patients in the adherent
group had lower future exacerbations, frequent exacerbations, and hos-
pitalisations. The patients in groups B and E who adhered to the GOLD
2023 report had lower future exacerbations, frequent exacerbations, and
hospitalisations, while no significant difference was observed in group
A (P < 0.0 5 ).
Conclusions In the real world, many patients with COPD do not receive
the initial inhalation therapy recommended by the GOLD 2023 report.
However, adherence to the GOLD 2023 report may decrease the risk of
future exacerbation. It implied that improved the dissemination and up-
take of GOLD 2023 recommendations is needed in the clinical practice.
© 2025 The Author(s)
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Inhalaon Therapy Recommendaons in COPD paents
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Online Supplementary
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Table 1
Figure 1
Figure 2
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PTable 2
Figure 1.
Figure 2.
Table 1.
Variables Total (n = 1654)
Male
Female
Junior high school and below
High school and over
Never smoker
Former smoker
Current smoker
Yes
No
1
2
3
4
Variables Total (n = 1654)
A
B
E
Chronic heart disease
Hypertension
Lung cancer
Diabetes
Bronchiectasis
LAMA
LABA+ICS
LAMA+LABA
LAMA+LABA+ICS
*
Inhalaon Therapy Recommendaons in COPD paents
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PTable 3
Online Supplementary Document
Table 2.
Variables Non-adherent (n = 838) Adherent (n = 816) P-value
Male
Female
Junior high school and below
High school and over
Never smoker
Former smoker
Current smoker
Yes
No
1
2
3
4
Chronic heart disease
Hypertension
Lung cancer
Diabetes
Bronchiectasis
t
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Supplementary DocumentP
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Table 3.
Variables OR 95% CI P-value†
Junior high school and below
High school and over
No
Yes
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Acknowledgments:
Ethics statement:
Data availability:
Funding:
Deng et al.
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Authorship contributions:
Disclosure of interest:
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