The Global Initiative for Chronic Obstructive Lung Disease (GOLD) has published Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease—2019 report.

Chronic obstructive pulmonary disease (COPD) is the second most common lung disease in the UK after asthma; almost 2% of the UK population live with COPD. In 2012, almost 30,000 people in the UK died as a result of their COPD.

Updates have been made to reflect key evidence from peer-reviewed publications between January 2017 and January 2018, as well as to improve the clarity of figures and tables.

New and updated topics discussed in line with the new evidence include:

Chapter 1

  • predisposition of women in developing countries to COPD from burning of fuels in cooking
  • the association between poverty and airway obstruction, and between lower socioeconomic status and COPD
  • increased COPD risk in patients with HIV.

Chapter 2

  • support for case finding based on primary care data and risk scores, or actively sending screening questionnaires.

Chapter 3

  • a new section on blood eosinophil count and updated sections on pulmonary rehabilitation and self-management
  • review of the effect of pneumococcal vaccination, its protection against community-acquired pneumonia, and related benefits in patients with COPD
  • more discussion of the evidence around the use of combination therapies in patients with a history of exacerbations.

Chapter 4

  • updated algorithms for the initiation of and follow-up management of pharmacological treatment, and new diagrams to improve clarity and bring them into line with the latest evidence
  • a discussion of the initiation of therapy and follow-up treatment, including escalation and de-escalation strategies
  • a revision of the non-pharmacological management section
  • an updated section on interventional bronchoscopy and surgery.

Chapter 5

  • nebulised budesonide in the treatment of exacerbations
  • intensified combination therapy with inhaled corticosteroids and long-acting beta2 agonists with onset of upper respiratory tract infection
  • the efficacy of added doxycycline in delaying exacerbations in an outpatient setting
  • high-flow nasal cannula oxygen therapy
  • non-invasive ventilation
  • telemonitoring.