A cross-sectional survey of current treatment and symptom burden of patients with COPD consulting for routine care according to GOLD 2014 classifications

Figures & data

Figure 1 GOLD group distribution by country according to objective GOLD classification.

Abbreviations: EU5, France, Germany, Italy, Spain, and UK; GOLD, Global Initiative for Chronic Obstructive Lung Disease.

Table 1 Patient characteristics according to objective GOLD classification

Characteristic	Overall n=1,641	Group A n=169	Group B n=742	Group C n=26	Group D n=704
Age (years)
Mean (SD)	65.8 (10.3)	62.6 (10.1)	65 (10.2)	61.6 (11.4)	67.6 (10.1)
Range	40.0–90.0	42.0–86.0	41.0–90.0	43.0–79.0	40.0–90.0
Gender
Male, n (%)	1,118 (68.1)	112 (66.3)	510 (68.7)	16 (61.5)	480 (68.2)
Smoking status	n=1,638	n=168	n=742	n=26	n=702
Current smoker (%)	541 (33.0)	58 (34.5)	246 (33.2)	10 (38.5)	227 (32.3)
Ex-smoker (%)	1010 (61.7)	98 (58.3)	450 (60.6)	14 (53.8)	448 (63.8)
Never smoked (%)	87 (5.3)	12 (7.1)	46 (6.2)	2 (7.7)	27 (3.8)
Physician responsible for treatment decisions	n=1,630	n=168	n=739	n=26	n=697
Primary care physician only, n (%)	704 (43.2)	84 (50.0)	333 (45.1)	12 (46.2)	275 (39.5)
Pulmonologist, n (%)	926 (56.8)	84 (50.0)	406 (54.9)	14 (53.8)	422 (60.5)
Most recent FEV1% predicted (post-bronchodilator)	n=745	n=76	n=303	n=14	n=352
Mean (SD)	63.7 (17.9)	74 (12.2)	72.4 (13.1)	55.6 (20.8)	54.2 (17.4)
95% CI	62.4, 64.9	71.2, 76.8	70.9, 73.9	43.6, 67.7	52.4, 56.1
CAT score	n=1,641	n=169	n=742	n=26	n=704
Mean (SD)	20.4 (8.4)	5.9 (2.4)	19.7 (6.0)	7.3 (2.2)	25.1 (6.8)
Exacerbations within previous 12 monthsa	n=1,625	n=167	n=731	n=26	n=701
0	724 (44.6)	146 (87.4)	513 (70.2)	3 (11.5)	62 (8.8)
1	320 (19.7)	21 (12.6)	218 (29.8)	4 (15.4)	77 (11.0)
2	283 (17.4)	0	0	15 (57.7)	268 (38.2)
≥3	298 (18.3)	0	0	4 (15.4)	294 (41.9)
Time since diagnosis (12-month split)	n=1,391	n=148	n=635	n=22	n=586
≤12 months, n (%)	287 (20.6)	60 (40.5)	150 (23.6)	2 (9.1)	75 (12.8)
>12 months, n (%)	1,104 (79.4)	88 (59.5)	485 (76.4)	20 (90.9)	511 (87.2)

Note:

a Exacerbations treated with oral corticosteroids, antibiotics, or both, or requiring emergency-room visits or hospitalization.

Abbreviations: CAT, COPD assessment test; CI, confidence interval; FEV₁, forced expiratory volume in 1 second; GOLD, Global Initiative for Chronic Obstructive Lung Disease; SD, standard deviation.

Table 2 Current treatment by objective GOLD group classificationa

Patients, n (%)	Group A n=169	Group B n=742	Group C n=26	Group D n=704	P-value
Short-acting only	32 (18.9)	66 (8.9)	0	10 (1.4)	<0.001
LABA	15 (8.9)	39 (5.3)	1 (3.8)	24 (3.4)	0.024
LAMA	57 (33.7)	198 (26.7)	2 (7.7)	52 (7.4)	<0.001
ICS/LABA	26 (15.4)	154 (20.8)	5 (19.2)	125 (17.8	0.304
ICS + LABA	1 (0.6)	4 (0.5)	0	11 (1.6)	0.213
ICS + LAMA	1 (0.6)	10 (1.3)	1 (3.8)	15 (2.1)	0.338
LAMA + LABA	14 (8.3)	60 (8.1)	2 (7.7)	52 (7.4)	0.959
ICS/LABA + LAMA	18 (10.7)	170 (22.9)	14 (53.8)	342 (48.6)	<0.001
ICS/LABA + LAMA + other	0	3 (0.4)	0	10 (1.4)	0.089
Other	5 (3.0)	38 (5.1)	1 (3.8)	63 (8.9)	0.005
Recommended by GOLD 2014 as first/alternative choice	Not listed by GOLD 2014 as first choice or alternative choice		Not determined

Note:

a Maintenance regimens include ± SABA, SAMA, or SABA/SAMA.

Abbreviations: GOLD, Global Initiative for Chronic Obstructive Lung Disease; ICS, inhaled corticosteroids; LABA, long-acting β₂-agonist; LAMA, long-acting muscarinic antagonist; SABA, short-acting β₂-agonist; SAMA, short-acting muscarinic antagonist.

Figure 2 Current treatment according to objective GOLD classification for patients managed by (A) a primary care physician or (B) pulmonologist.^a

Notes: *P<0.05; ***P<0.0001 across GOLD groups A–D. ^aMaintenance regimens include ± SABA, SAMA, or SABA/SAMA.
Abbreviations: GOLD, Global Initiative for Chronic Obstructive Lung Disease; ICSs, inhaled corticosteroids; LABA, long-acting β₂-agonist; LAMA, long-acting muscarinic antagonist; SABA, short-acting β₂-agonist; SAMA, short-acting muscarinic antagonist.

Figure 3 Current treatment according to objective GOLD classification for patients diagnosed (A) ≤12 months or (B) >12 months.^a

Notes: *P<0.05; **P<0.01; ***P<0.0001 across GOLD groups A–D. ^aMaintenance regimens include ± SABA, SAMA, or SABA/SAMA.
Abbreviations: GOLD, Global Initiative for Chronic Obstructive Lung Disease; ICS, inhaled corticosteroids; LABA, long-acting β₂-agonist; LAMA, long-acting muscarinic antagonist; SABA, short-acting β₂-agonist; SAMA, short-acting muscarinic antagonist.

Table 3 Current treatment and proportion of patients with well-controlled symptoms by CAT

Patients, n (%)	CAT
	0–9 n=195	10–19 n=520	20–29 n=676	30–40 n=250	Overall n=1,641
Short-acting only	32 (16.4)	30 (5.8)	40 (5.9)	6 (2.4)	108 (6.6)
LABA	16 (8.2)	27 (5.2)	30 (4.4)	6 (2.4)	79 (4.8)
LAMA	59 (30.3)	141 (27.1)	93 (13.8)	16 (6.4)	309 (18.8)
ICS/LABA	31 (15.9)	97 (18.7)	136 (20.1)	46 (18.4)	310 (18.9)
ICS + LABA	1 (0.5)	2 (0.4)	7 (1.0)	6 (2.4)	16 (1.0)
ICS + LAMA	2 (1.0)	9 (1.7)	8 (1.2)	8 (3.2)	27 (1.6)
LAMA + LABA	16 (8.2)	39 (7.5)	57 (8.4)	16 (6.4)	128 (7.8)
ICS/LABA + LAMA	32 (16.4)	140 (26.9)	251 (37.1)	121 (48.4)	544 (33.2)
ICS/LABA + LAMA + other	0	2 (0.4)	7 (1.0)	4 (1.6)	13 (0.8)
Other	6 (3.1)	33 (6.3)	47 (7.0)	21 (8.4)	107 (6.5)
Patients with completely controlled or well-controlled COPD in past 4 weeks, n (%)
Physician reported	157 (80.5)	359 (69.0)	321 (47.5)	45 (18.0)	882 (53.7)
Patient reported	168 (86.2)	314 (60.4)	241 (35.7)	40 (16.0)	763 (46.5)

Abbreviations: CAT, COPD assessment test; GOLD, Global Initiative for Chronic Obstructive Lung Disease; ICS, inhaled corticosteroid; LABA, long-acting β₂-agonist; LAMA, long-acting muscarinic antagonist.