The CO-MIND Study: Chronic Obstructive Pulmonary Disease Management in Daily Practice and Its Implications for Improved Outcomes According to GOLD 2019 Perspective

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dc.authoridGunen, Hakan/0000-0001-6631-4457
dc.authoridAkgun, Metin/0000-0003-3404-4274
dc.authoridOzkaya, Sevket/0000-0002-8697-4919
dc.authoridYildiz, Birsen Pinar/0000-0002-6650-1495
dc.authoridBayram, Nazan/0000-0002-4692-2639
dc.contributor.authorGunen, Hakan
dc.contributor.authorKokturk, Nurdan
dc.contributor.authorNayci, Sibel
dc.contributor.authorOzkaya, Sevket
dc.contributor.authorYildiz, Birsen Pinar
dc.contributor.authorTuran, Onur
dc.contributor.authorGumus, Aziz
dc.date.accessioned2025-01-27T21:03:42Z
dc.date.available2025-01-27T21:03:42Z
dc.date.issued2022
dc.departmentÇanakkale Onsekiz Mart Üniversitesi
dc.description.abstractPurpose: GOLD 2019 proposed a novel treatment decision tool for follow-up based on the predominant trait (exacerbation or dyspnea) of patients, alongside treatment escalation and de-escalation strategies. This study was designed to provide an up-to-date snapshot of patient and disease characteristics, treatment pathways, and healthcare resource use (HRU) in COPD in real life, and comprehensively examine patients considering GOLD 2019 recommendations.Patients and Methods: This mixed design, observational, multicenter (14 pulmonology clinics) study included all patients with a documented COPD diagnosis (excluding asthma-COPD overlap [ACO]) for >12 months, aged >40 years at diagnosis who had a COPD-related hospital visit, spirometry test and blood eosinophil count (BEC) measurement under stable conditions within the 12 months before enrollment between February and December 2020. Data were collected cross-sectionally from patients and retro-spectively from hospital medical records. Results: This study included 522 patients (GOLD group A: 17.2%, B: 46.4%, C: 3.3%, D: 33.1%), of whom 79.5% were highly symptomatic and 36.2% had high risk of exacerbation. Exacerbations (n = 832; 46.6% moderate, 25.5% severe) were experienced by 57.5% of patients in the previous 12 months. Inter-rater agreement between investigators and patients regarding the reason for visit was low (Kappa coefficient: 0.338, p = 0.001). Inhaled treatment was modified in 88 patients at index, mainly due to symptomatic state (31.8%) and exacerbations (27.3%); treatment was escalated (57.9%, mainly switched to LABA+LAMA+ICS), inhaler device and/or active ingredient was changed (36.4%) or treatment was de-escalated (5.7%). 27% had >1 hospital overnight stay over 12 months. Emergency department visits and days with limitation of daily activities were higher in group D (p < 0.001). Conclusion: Despite being on-treatment, many patients with COPD experience persistent symptoms and exacerbations requiring hospital-related HRU. A treatable trait approach and holistic disease management may improve outcomes by deciding the right treatment for the right patient at the right time.
dc.description.sponsorshipGlaxoSmithKline [208435]
dc.description.sponsorshipThis study was funded by GlaxoSmithKline (GSK study 208435) . Volkan Eken and Hakan Erkus are GlaxoSmithKline Pharmaceuticals employees and shareholders. The other authors report no other conflicts of interest in this study.
dc.identifier.doi10.2147/COPD.S372439
dc.identifier.endpage1895
dc.identifier.issn1178-2005
dc.identifier.pmid36003323
dc.identifier.scopus2-s2.0-85136305954
dc.identifier.scopusqualityQ1
dc.identifier.startpage1883
dc.identifier.urihttps://doi.org/10.2147/COPD.S372439
dc.identifier.urihttps://hdl.handle.net/20.500.12428/27410
dc.identifier.volume17
dc.identifier.wosWOS:000849801300001
dc.identifier.wosqualityQ3
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherDove Medical Press Ltd
dc.relation.ispartofInternational Journal of Chronic Obstructive Pulmonary Disease
dc.relation.publicationcategoryinfo:eu-repo/semantics/openAccess
dc.rightsinfo:eu-repo/semantics/openAccess
dc.snmzKA_WoS_20250125
dc.subjectCOPD
dc.subjectGOLD
dc.subjectexacerbation
dc.subjectCOPD treatment
dc.subjecteosinophilia
dc.titleThe CO-MIND Study: Chronic Obstructive Pulmonary Disease Management in Daily Practice and Its Implications for Improved Outcomes According to GOLD 2019 Perspective
dc.typeArticle

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