After Going MIA for 2018 the GOLD COPD App Returns for 2019
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 2019 Global Initiative for Chronic Obstructive Pulmonary Disease (GOLD) guidelines. Smoking remains the most common cause of COPD and remains relevant despite the recent decrease in tobacco use in the United States. And even though there was no update for 2018, the GOLD COPD was recently updated.
Though the nation currently faces an explosion of e-cigarette use especially in teenagers. 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 2019 GOLD guidelines then recommend “grading” a patient via the revised ABCD assessment. Very few interventions decrease mortality for chronic COPD: smoking cessation and oxygen. Non-pharmacologic and pharmacologic treatment is then based on the revised 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 2019 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 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 was last updated in 2017,
Evidence-based medicine
The app includes the current “gold standard” GOLD COPD guidelines released in 2019 in app form. The app includes a toolkit that walks providers through the revised 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 includes links to the full PDFs with evidence ratings and references.
Who would benefit from this App?
Any healthcare provider who cares for COPD patients including students, NPs, PAs, family medicine, internal medicine, pulmonologists, and geriatricians.
Price
o Free.
Likes
o Only app containing the current 2019 GOLD COPD guidelines
o Includes revised ABCD assessment, CAT, mMRC, and treatment selector calculators
o Available for Android
Dislikes
o Doesn’t include evidence rating for recommendations
o Lots of wasted space and some viewing issues (at least on my devices)
o App not as intuitively designed as it could be
Overall
The GOLD 2019 COPD Pocket Guide app brings the GOLD guideline PDF to life on mobile devices. It is the only COPD app you likely will need. The revised ABCD patient assessment tool 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
o 4.5 stars
User Interface
o 4.0 stars
Easy to use interface, but not as intuitive or advanced as it should be given the source (though now the app is free). Interactive tools remain front and center.
Multimedia Usage
o 5.0 stars
App includes the revised ABCD COPD patient assessment calculator, the CAT and mMRC symptom calculators, and a treatment selector calculator along with a PDF of the guideline.
Price
o 5 stars
App is free.
Real-World Applicability
o 4.5 stars
The GOLD 2019 COPD Pocket Guide is the ideal companion app to the guidelines. The app gives you the key points of the guideline while making it much easier to put to use at the point of care via the Diagnosis section. The app like the guideline still contains a lot of expert-opinion recommendations.
Device Used For Review
o iPhone 8S running iOS 12.3.1
Available for Download for iPhone, iPad, and Android.
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.
