Rational monitoring of COPD: where do current clinical guidelines stand?

The Global Initiative for Chronic Obstructive Lung Disease (GOLD) guideline serves as an international reference for evidence-based management of patients with chronic obstructive pulmonary disease (COPD) 1. Based on the available scientific evidence, recommendations for diagnosis and treatment are presented. An important goal of the GOLD initiative is to counter the nihilistic attitude and to promote a proactive engagement of physicians and allied healthcare professionals with COPD patients over time 2. In addition, GOLD, and also other guidelines, recommend regular surveillance of patients' respiratory health status 1, 3–19. The rationale behind the regular follow-up of patients with chronic conditions, also referred to as “monitoring”, is that it facilitates optimal outcome of patient care 20, 21. However, care of COPD implicates large numbers of patients and, consequently, monitoring their health status would result in substantial use of healthcare resources. In the present paper, the authors reflect on monitoring, as currently recommended in COPD guidelines, and discuss the rationale behind it, including some pros and cons of the procedures involved. A total of 18 clinical guidelines published or updated after the year 2000 that address the diagnosis, treatment and (end-of-life) care …