When deciding the appropriate pharmacotherapy, GOLD guidelines are very clear in the subjective monitoring of the patient, rather than severity of disease. The aim of pharmacotherapy is to reduce symptoms and reduce future risk.
As highlighted in the most recent GOLD COPD guidelines (above), airflow limitation (FEV1) alone is a poor descriptor of the disease status, and therefore the degree of airflow limitation is defined by symptom severity and exacerbation frequency. Four categories (A–D) have been established in which patients can be grouped.
In addition, GOLD have a model for pharmacological management for each category which is based on the most recent evidence for COPD pharmacotherapy.