January 2017 saw the publication of new global COPD Guidelines (referred to as GOLD 2017 ). These guidelines, which include several major changes on the recommendations for the prevention, diagnosis, and management of COPD in primary care, are based on new evidence published in the last two years.
The changes relate to the ABCD grouping tool, escalation and de-escalation strategies for pharmacological intervention, non-pharmacologic therapies and medical comorbidities.
The 1234 classification of spirometry has been removed from the ABCD grouping tool, which now derives exclusively from patient symptoms and their history of exacerbations. This does not mean that spirometry is not required but simply that the assessment of COPD has been refined to separate the diagnosis attained via spirometry from the symptoms and exacerbation risk.
Another significant change contained in Gold 2017 relates to the recommended pharmacological treatments for each of the Groups A to D and their escalation strategies.
New recommendations are also presented with regard to self-management and education programmes, the use of inhaled corticosteroids, outpatient transition criteria and new evidence for pulmonary rehabilitation and palliative care.