PT - JOURNAL ARTICLE AU - John Haughney AU - Kevin Gruffydd-Jones AU - June Roberts AU - Amanda J Lee AU - Alison Hardwell AU - Lorcan McGarvey TI - The distribution of COPD in UK general practice using the new GOLD classification AID - 10.1183/09031936.00065013 DP - 2014 Apr 01 TA - European Respiratory Journal PG - 993--1002 VI - 43 IP - 4 4099 - http://erj.ersjournals.com/content/43/4/993.short 4100 - http://erj.ersjournals.com/content/43/4/993.full SO - Eur Respir J2014 Apr 01; 43 AB - The new Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2011 document recommends a combined assessment of chronic obstructive pulmonary disease (COPD) based on current symptoms and future risk. A large database of primary-care COPD patients across the UK was used to determine COPD distribution and characteristics according to the new GOLD classification. 80 general practices provided patients with a Read code diagnosis of COPD. Electronic and hand searches of patient medical records were undertaken, optimising data capture. Data for 9219 COPD patients were collected. For the 6283 patients with both forced expiratory volume in 1 s (FEV1) and modified Medical Research Council scores (mean±sd age 69.2±10.6 years, body mass index 27.3±6.2 kg·m−2), GOLD 2011 group distributions were: A (low risk and fewer symptoms) 36.1%, B (low risk and more symptoms) 19.1%, C (high risk and fewer symptoms) 19.6% and D (high risk and more symptoms) 25.3%. This is in contrast with GOLD 2007 stage classification: I (mild) 17.1%, II (moderate) 52.2%, III (severe) 25.5% and IV (very severe) 5.2%. 20% of patients with FEV1 ≥50% predicted had more than two exacerbations in the previous 12 months. 70% of patients with FEV1 <50% pred had fewer than two exacerbations in the previous 12 months. This database, representative of UK primary-care COPD patients, identified greater proportions of patients in the mildest and most severe categories upon comparing 2011 versus 2007 GOLD classifications. Discordance between airflow limitation severity and exacerbation risk was observed. GOLD 2011 COPD classification criteria identified more patients in the mildest and more severe groups than GOLD 2007 http://ow.ly/t4uiO