Guidelines for a variety of diseases have now been produced.
However, implementation of guidelines requires that the medical
profession is willing to conform to patterns of diagnostic and
treatment behavior set down by others. This may not happen in practice.
Early experience in the United Kingdom was gained with the introduction
of guidelines for the management of asthma. For a number of years,
there have been improvements in practice, but deficiencies still exist.
When the introduction of guidelines for the management of COPD was
planned, a new approach was taken with a consortium of the British
Thoracic Society, pharmaceutical companies, and medical equipment
companies being formed to promote their use. Early studies show that
COPD care starts from an even lower baseline than asthma; there is poor
understanding of objective diagnosis of COPD in both primary and