COPD is defined as a “common preventable and treatable disease, characterized by airflow limitation that is usually progressive and associated with an enhanced chronic inflammatory response in the airways and the lung to noxious particles or gases. Exacerbations and comorbidities contribute to the overall severity in patients.” This definition comes from the 2017 Global Initiative for Chronic Obstructive Pulmonary Disease (GOLD) guidelines. Smoking remains the most common cause of COPD, and it remains highly relevant despite the recent decrease in tobacco use in the United States. COPD remains the third leading cause of death.
To make a formal diagnosis of COPD, providers must perform spirometry. A postbronchodilator FEV1/FVC < 70% is consistent with a diagnosis of COPD. Spirometry classifications are then broken down by the patient’s FEV1. The 2017 GOLD guidelines then recommend “grading” a patient via the ABCD assessment. Very few interventions decrease mortality for chronic COPD: smoking cessation and oxygen. Non-pharmacologic and pharmacologic treatment is then based on the ABCD assessment grade. The drug market has exploded with new treatments for COPD over the past five years. Physicians are inundated with inhaler acronyms: SABA, SAMA, LAMA, LABA, ICS, and combinations of the above. The problem with most guidelines like this is the lack of tools to help providers accomplish these tasks at the point of care during a busy clinic. How are physicians to know which medications should be utilized and in what sequence? The new GOLD COPD 2017 guidelines have been released with a companion app of the GOLD Pocket Guide that aims to make this process easy to complete.
Previously on iMedicalApps, we favorably reviewed the COPD Pocket Consultant app by GlaxoSmithKline. Despite its Big Pharma backing, the app was the only one available that included a number of the COPD symptom questionnaires such as the COPD Assessment Test (CAT). The other commonly used symptom questionnaire — the modified Medical Research Council Scale (mMRC) — can be found on the medical calculator app MedCalx. The prior “official” GOLD app hasn’t been updated since 2015, and COPD Pocket Consultant doesn’t include the 2017 guidelines. Now that the GOLD 2017 COPD Pocket Guide is available, will it become the new king of the COPD apps?
The app includes the current “gold standard” GOLD COPD guidelines released in 2017 in app form. The app includes a toolkit that walks providers through the recommended ABCD patient assessment, symptom assessment with calculators of the two most recommended COPD patient assessment questionnaires–COPD Assessment Test (CAT) and the mMRC–and a treatment selector based on these assessments. Although the GOLD guidelines are evidence-based, many of their recommendations are expert opinion. The app does not include the evidence rating for any of its recommendations or links to the references included in the full online guideline.
Who would benefit from this COPD App?
Any healthcare provider who cares for COPD patients including students, NP’s, PA’s, Family Medicine, Internal Medicine, Pulmonologists, and Geriatricians.
Disclaimer: The views expressed are those of the author(s) and do not reflect the official policy of the Department of the Army, the Department of Defense or the U.S. Government.
- Only app containing the current GOLD COPD guideline
- Includes ABCD assessment, CAT, mMRC calculators, and treatment selector calculators
- Includes patient handout on COPD
- Available for Android
- Doesn’t include evidence rating for recommendations
- No complete PDF of guideline, just pocket guide
- Podcast function not available — yet
- App can be trickier to navigate than it needs to be
The GOLD 2017 COPD Pocket Guide app brings the GOLD guideline PDF to life on the iPhone. It is now the undisputed king of COPD apps as it is the most current and contains the most tools for providers to use at the point of care. The ABCD patient assessment toolkit allows providers to properly classify and treat patients at the point of care without paging through a long PDF. The caveat is that the evidence of efficacy for many COPD medications is weak when it comes to true patient-oriented outcomes, and the GOLD guidelines contain a significant amount of expert opinion and pharmaceutical company ties.
- Overall Score
- User Interface
Easy to use interface with interactive tools front and center and the rest of the guideline divided into logical sections for rapid access and review.
- Multimedia Usage
App includes the ABCD COPD patient assessment calculator, the CAT and mMRC symptom calculators, and a treatment selector calculator along with a PDF of the guideline.
App is $2.99. PDF of guideline is free.
- Real World Applicability
The GOLD 2017 COPD Pocket Guide is the perfect companion app to the guidelines. By including numerous interactive tools for assisting in completing the recommended COPD patient assessment and non-pharmacologic and pharmacologic treatments, the app brings the guideline to life making it much more likely providers will comply with its recommendations–though some of those are clearly expert-opinion.
- Device Used For Review
iPhone 6S running iOS 10.3.2
- Available for DownloadAndroidiPhoneiPad