COPD: Five reasons why new GOLD classification won't work for China

Commentary by Nina Sheng in The Lancet says the new 2013 GOLD criteria are unsuitable for China and other developing countries because:
1. Many doctors have a low level of training and may not be aware of guidelines or lack skills to implement them.
2. Clinicians in China are very busy seeing up to 80 patients a day and may nt have time to apply GOLD diagnostic questionnaire criteria.
3. Spirometry not widely available.
4. Patients do not self manage COPD exacerbations well - over-reliance on antibiotics, underuse and misuse of inhalers/steroids.
5. Medications are expensive - only the wealthy can afford them.