Is the Treatment of Copd in Accordance with The Guidelines of Gold in Algeria?

Despite the availability of national and international recommendations, it should be noted that treatment of chronic obstructive pulmonary disease (COPD) does not always follow the recommendations. This study evaluated the current management of patients with COPD at their first visit to the Pulmonology Service consultation. Constantine Regional Military University Hospital Methods Sixty-one consecutive patients with spirometry-confirmed stable COPD were included after obtaining informed written consent. Demographic and clinical data, spirometric values, 6-minute walking distance, BMI and current treatment were collected for analysis. This is a prospective study conducted at Constantine Regional Military University Hospital Results Long-acting bronchodilators without inhaled corticosteroids were prescribed in 52.5% of patients, with a preference for LABA (21.3%) over LAMA (8.2%). The combination LABA + LAMA was used in 23% of patients. The unavailability and cost of LAMA could explain this difference in prescription. Inhaled corticosteroids were used by 39.3% of patients, with overrepresentation in B and D (66.66%). None of our patients received inhaled corticosteroids alone, or PDE4 inhibitors or theophylline At the time of the first consultation, 93.4% of our cohort patients were on treatment for COPD. Among those not treated, the majority were in the mild (75%) and moderate (25%) severity groups. Approximately 26.2% of patients received a combination of short-acting bronchodilators (SABA) + two long-acting bronchodilators (LABA + LAMA) + inhaled corticosteroids (IC), with higher prevalence in the most symptomatic groups (B and D), 75%. Conclusions The guidelines were not followed in their great majority, so COPD is not treated according to the recommendations of the GOLD, it happens that some patients do not receive any treatment despite the emergence of symptoms. ICS are commonly administered to patients under treatment, regardless of the severity of airflow limitation. Abréviations: CAT, COPD Assessment Test ; BPCO, maladie pulmonaire obstructive chronique ; VEMS , volume expiratoire maximal en 1 seconde ; GOLD, Global Initiative for Chronic Obstructive Lung Disease ; mMRC, Medical Research Council modifié, corticostéroïdes inhalés (CSI), bêta2- agonistes à action prolongée : (LABA) antagoniste muscarinique à action prolongée :( LAMA)