Aims: Data on differences in clinical characteristics and management of COPD in different countries and settings are limited. We aimed to characterize the profi le of patients with COPD in a number of countries and their treatment in order to evaluate adherence to recommendations of international guidelines. Method: This was an observational, international, cross-sectional study on patients with physician-diagnosed COPD. Demographic and clinical characteristics, risk factors, and treatment were collected by their physician via an internet web-based questionnaire developed for the study. Results: A total of 77 investigators from 17 countries provided data on 833 patients. The countries with the highest number of patients included were: Argentina (128), Ecuador (134), Spain (162), and Hong Kong (153). Overall, 79.3% were men and 81% former smokers, with a mean FEV 1 = 42.7%, ranging from 34.3% in Hong Kong to 58.8% in Ecuador. Patients reported a mean of 1.6 exacerbations the previous year, with this frequency being signifi cantly and negatively correlated with FEV 1 (%) (r = -0.256; p Ͻ 0.0001). Treatment with short-acting bronchodilators and theophyllines was more frequent in Ecuador and Hong Kong compared with Spain and Argentina, and in patients belonging to lower socioeconomic levels (p Ͻ 0.0001 for all comparisons). Inadequacy of treatment with inhaled corticosteroids and theophyllines was high, with signifi cant differences among countries. Conclusions: Differences in the clinical characteristics and management of COPD were signifi cant across countries. Adherence to international guidelines appears to be low. Efforts should be made to disseminate and adapt guidelines to the socioeconomic reality of different settings.

COPD patients who incur higher healthcare resource utilisation show reduced physical activity, increased respiratory failure and increased systemic inflammation.

Nearly one-quarter of the patients with COPD in this study presented clinically significant depression associated with worse quality of life, reduced exercise capacity, greater dyspnea, and a higher score in the BODE index.

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