Table 2.

Comparison between GOLD guideline recommendations and services available in hospitals in the Eastern province in Saudi Arabia

GOLD recommendations	Hospitals in the Eastern province (n=22)
Specialized care for respiratory diseases	No respiratory departments and only 13.6% of hospitals (n=3) have a specific respiratory outpatient clinic
Spirometry is required to make the diagnosis of COPD	Five hospitals (22.7%) have spirometry available
COPD assessment must consider the following aspects of the disease separately: current level of patient’s symptoms, severity of the spirometric abnormality, exacerbation risk, and presence of comorbidities	No information available
Pulmonary rehabilitation (PR) program and physical activity is recommended for all patients with COPD	No PR program and physical activity are offered to patients with COPD
Oxygen therapy is recommended for patients with chronic respiratory failure	Eight hospitals (36.6%) offer long-term oxygen therapy for patients with COPD
Noninvasive ventilation (NIV) has been shown to improve acute respiratory acidosis	Seven hospitals (31.8%) offer noninvasive ventilation
Invasive mechanical ventilation is need when patients unable to tolerate noninvasive mechanical ventilation (severe exacerbations)	Twelve hospitals (54.5%) offer invasive mechanical ventilation
Immediate admission to ICU when is needed	Eight hospitals (36.6%) have an ICU
Smoking cessation is the key intervention for all patients with COPD who continue to smoke	No information available
Pharmacologic therapy such as short-acting anticholinergic, short-acting bronchodilator, long-acting anticholinergic, long-acting beta2-agonist, and inhaled corticosteroid is recommended for patients with COPD	No information available

Abbreviations: GOLD, Global Initiative for Chronic Obstructive Lung Disease; ICU, intensive care unit.