REVIEW ARTICLE


Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2023 Guidelines Reviewed Alternate Title: Global Initiative for Chronic Obstructive Lung Disease (GOLD)



Munish Sharma1, Sushil Joshi2, Prakash Banjade3, Shekhar A Ghamande4, Salim Surani5, *
1 Division of Pulmonary, Critical Care and Sleep Medicine, Baylor Scott and White Medical Center, Temple, Texas
2 Department of Medicine, Mantra Hospital and Research Center, Kanchanpur, Nepal. Nepalese Army Institute of Health Science, Kathmandu, Nepal
3 Department of Medicine, Manipal College of Medical Sciences, Pokhara, Nepal
4 Division of Pulmonary, Critical Care and Sleep Medicine, Baylor Scott and White Medical Center, Baylor College of Medicine, Temple, Texas
5 Adjunct Clinical Professor of Medicine, Texas A and M University, Texas, United States


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Creative Commons License
© 2024 The Author(s). Published by Bentham Open.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Correspondence: Address correspondence to this author at the Adjunct Clinical Professor of Medicine, Texas A and M University, Texas, United States; E-mail: srsurani@hotmail.com


Abstract

The Global Initiative for Chronic Obstructive Lung Disease (GOLD) report is an essential resource for all clinicians who strive to provide optimal care to patients with chronic obstructive lung disease (COPD). The annual report of GOLD makes few revisions and updates besides including data from the preceding year. At an interval, GOLD comes up with a significant modification in its guidelines, which is generally a major overhaul of the pre-existing guidelines. According to the latest 2023 updates, published in November 2022, there have been significant advancements made in the field of COPD. These include the development of more precise definitions for COPD and its exacerbations, the introduction of a new set of parameters to measure exacerbation severity, and updating the COPD assessment tool. Additionally, revisions have been made to the initial and follow-up treatment guidelines. The report also simplifies the treatment algorithm and sheds light on new findings that suggest the use of pharmacological triple therapy can reduce mortality rates. Furthermore, the report includes discussions on inhaler device selection and adherence to COPD medications. These improvements demonstrate a continued effort to enhance COPD treatment and management. Although there are some areas that could benefit from more detailed guidance and explanation, such as the proper utilization of blood eosinophil counts for treatment decisions, and the establishment of treatment protocols post-hospitalization, the latest modifications to the GOLD recommendations will undoubtedly aid healthcare providers in addressing any gaps in patient care. We aim to highlight key changes in the GOLD 2023 report and present a viewpoint about their potential implications in a real-world clinical scenario.

Keywords: Chronic obstructive lung disease, Bronchoscopy, Computed tomography chest, Global initiative for chronic obstructive lung disease, Inhalers, Preserved ratio impaired spirometry.