Changing paradigms in chronic obstructive pulmonary disease-translation of practice guidelines in clinical practice

Chronic obstructive pulmonary disease (COPD) is a chronic debilitating disease, rising in incidence and prevalence, exerting an increasing impact on global morbidity and mortality. Despite this, many patients fail to be diagnosed or receive timely and appropriate treatment. In an attempt to improve awareness and standardise treatments across the globe, the Global Initiative for Obstructive Lung Disease (GOLD) was founded in 1998. GOLD guidelines are annually updated and published, offering physicians guidance on how to diagnose and manage COPD, based on the very latest evidence. In December 2011, the GOLD guidelines underwent a major revision, with significant changes in the recommended approach to assessment and management of COPD. In this review, the authors outline the key changes published in the 2011 GOLD update and consider how these evidence-based, but sometimes theoretical recommendations, translate into clinical practice.