I.N. Salakhova (1), A.R. Vafina (1), I.Yu. Vizel (1), A.A. Vizel (1), V.I. Ilyinsky (2), G.R. Shakirova (1, 2), E.Z. Kudryavtseva (3)

1) Kazan State Medical University, Kazan, Republic of Tatarstan; 2) Republican Clinical Hospital, Kazan, Republic of Tatarstan; 3) City Clinical Hospital №16, Kazan, Republic of Tatarstan
Background. Chronic obstructive pulmonary disease (COPD) is an environmentally mediated disease and is one of the five leading causes of mortality in the world. Rapid changes in the rearrangement of patients with COPD in the new GOLD classifications caused much discussion in the literature. Objective: Evaluation of the actual clinical practice and distribution of COPD patients according to different criteria. Methods. In hospital settings, 142 patients with COPD were examined – 140 men and 2 women, with mean age 64.8 ±0.7 (8.2) years. All patients underwent a physical examination, survey using standardized CAT and mMRC questionnaires, as well as spirography. Results. According to the GOLD-2007 classification, patients were distributed as follows: GOLD I – in 7%, GOLD II – in 31%, GOLD III – in 41.5%, and GOLD IV – in 20.5%. According to ABCD GOLD-2011 classification, 5.6% of patients were classified as type A, 10.6% – as type B, 1.4% – type C, and 82.4% – type D, and after redistribution according to ABCD GOLD-2017 – 6.3%, 13.4, 0.7 and 79.6%, respectively. Such a factor as hospitalization has changed the distribution of patients in ABCD groups. 93.7% of respondents have received short-acting bronchodilators (SABs), 60.6% – long-acting adrenomimetics, 23.9% – long-acting anticholinergics,
55.6% – inhaled glucocorticosteroids with long-acting bronchodilators, 14.8% – double bronchodilation, and 13.4% – triple therapy. 27.5% of patients had good treatment compliance. 72.5% of the patients were well trained by the health care providers for the correct use of their inhalers. Among all medications, patients preferred SABs and pressurized metered-dose inhalers, and they would like to use them only on demand. Most patients called morning the worst time of the day. Conclusion. The study reflects the dynamism in the diagnosis and treatment of COPD, the change of priorities from clinical physiology to anamnestic data, as well as the impact of spirometry refusal on ABCD classification. The main directions that will improve the quality of treatment of patients with COPD in the studied region were revealed: increasing the adherence of doctors to national clinical recommendations, and patients – to the prescriptions of attending physicians.
Keywords: chronic obstructive pulmonary disease, GOLD, clinical recommendations, therapeutic cooperation

About the Autors

Corresponding author: A.A. Vizel – МD, Prof., Head of Department of Phthisiopulmonology, Kazan State Medical University, Kazan, Republic of Tatarstan, Russia; ORCID:

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