Evaluation of Evidence from epidemiological studies shows that the prevalence varying from country to country between the range of 3% and 10% of the population. A meta-analysis of studies that have estimated the population-based prevalence of COPD from 1990 to 2004 in 28 countries gives the pooled prevalence of COPD as 7.5%. (2).The second reason lies in the severe health consequences that COPD poses. Present estimates of the World Health Organization (WHO) are that COPD is the twelfth commonest cause of morbidity and the fourth most common cause of death all around the world, estimated at 2.75 million. Future predictions of the WHO presents an even more bleak picture, with the forecast by 2020 being that COPD is likely to become the fifth most common cause of morbidity and the third commonest cause of death, pushing its annual contribution of death rate to 4 million. (2). The third reason is the huge economic costs that the COPD poses to society. Analysis of data available on the economic costs of COPD on healthcare in the U.S. and the U.K. in 1996 shows that in the U.S. the annual economic costs due to COPD were US$ 14.5 billion and in the U.K. it was 2.1 billion pounds. (2).The final reason is that COPD being a multi-component disorder no single approach or therapeutic agent has proven to be effective in arresting the decline of lung function and the progress of the disease. (3).The result of the combined effort by the National Heart, Lung and Blood Institute (NHLBI), and the WHO in 2001 resulted in the development of a new generation of evidence-based guidelines as a core resource in the management of COPD. This guideline is called the Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Diseases (GOLD). (4).The European Respiratory Society (ERS) guidelines form the basis of the GOLD guidelines. The ERS guidelines take into consideration the varying severity of the disease and the symptoms of the disease, based on which is the recommendation for the use of medications for COPD.
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