• Elif Sen, Salih Zeki Guclu, Isil Kibar, Ulku Ocal, Veysel Yilmaz, Onur Celik, Filiz Cimen, Fusun Topcu, Meltem Orhun, Hikmet Tereci, Aylin Konya, Idilhan Ar, and Sevgi Saryal.
• Department of Pulmonary Diseases, Ankara University School of Medicine, Ankara, Turkey.
• Int J Chron Obstruct Pulmon Dis. 2015 Jan 1; 10: 2657-63.

BackgroundLow adherence to Global initiative for chronic Obstructive Lung Disease (GOLD) guideline recommendations has been reported worldwide. There has been no study on the adherence to GOLD guidelines for COPD treatment in Turkey.ObjectivesTo investigate the rates of adherence to GOLD 2010 guidelines for COPD treatment among pulmonologists.DesignA multi-center, cross-sectional, observational study was carried out in eleven pulmonary outpatient clinics across Turkey. Adherence to GOLD was evaluated through hospital records. Demographic and clinical data were recorded.ResultsStudy included 719 patients (mean age: 62.9±9.7 years; males 85.4%) of whom 16 was classified as GOLD Stage I, 238 as II, 346 as III, and 119 as IV, and only 59.5% received appropriate treatment. Rates of guideline adherence varied across GOLD stages (I, 6.3%; II, 14.7%; III, 84.4%; and IV, 84%). Causes of inappropriate therapies were overtreatment (Stage I, 100% and Stage II, 91.1%), undertreatment (Stage III, 3.3% and Stage IV, 10.9%) and lack of treatment (Stage II, 3.8%; Stage III, 2.3%; and Stage IV, 5.9%). The most preferred regimen (43.4%) was long-acting β2-agonist-inhaled corticosteroid-long-acting muscarinic antagonist. Overall, 614 patients (89%) received treatment containing inhaled corticosteroid.ConclusionPulmonologists in Turkey have low rates of adherence to GOLD guidelines in COPD treatment. Inappropriateness of therapies was due to overtreatment in early stages and excessive use of inhaled corticosteroid (ICS) in all disease stages.

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