AIM: 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.

MATERIALS AND 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.

CONCLUSION: 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.

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Published in International Journal of Chronic Obstructive Pulmonary Disease, v. 10, no. 1, p. 39-55.

© 2015 Davis et al.

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The authors would like to acknowledge editorial support in the form of draft manuscript development, assembling tables and figures, collating author comments, and copyediting, which was provided by Kate Hollingworth of Continuous Improvement Ltd. The authors would like to further acknowledge the analytical support provided by Joe Maskell. This support was funded by GlaxoSmithKline (GSK).

This study was funded by GSK.

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Table S1: Definitions used to identify responses concordant with the GOLD global strategy treatment recommendations

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Table S2: Tests typically used to establish a COPD diagnosis by country and by physician type

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Table S3: Key indicators for considering a COPD diagnosis: GOLD global strategy by country and by physician type

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Table S4: Proportion of primary care physicians and respiratory specialists concordant with first- or second-choice GOLD 2011 global strategy treatment options by country