How patients act in response to COPD exacerbations: results from a multi-country survey

<bold>Background:</bold> Appropriate self-management of exacerbations is recommended in COPD to improve patients’ outcomes. <bold>Objectives:</bold> To describe healthcare-seeking behaviour and actions taken by people living with COPD during exacerbations. <bold>Methods:</bold> A survey consisting of 26 multiple-choice questions was developed using a targeted literature review and further informed by patients and a panel of COPD experts. People living with COPD were recruited from survey research panels in Brazil, China, Europe and the USA and responded to the survey online (March–May 2023). Here, we describe healthcare-seeking behaviour and coping strategies reported by respondents with a history of exacerbation(s). <bold>Results:</bold> Out of 857 respondents, 671 (78%) reported ever having had an exacerbation. Regarding healthcare-seeking behaviour, only 74% (n=497) reported contacting their clinician for advice within 2 days of exacerbation onset. The most common action taken was ‘more often than usual’ inhaler use (n=389; 58%). Of those respondents who did not increase inhaler use, the most common non-mutually exclusive actions taken were practising breathing techniques (n=114; 40%), contacting a healthcare provider (n=101; 36%), carrying out activities ‘more slowly than usual’ (n=97; 34%) and stopping doing any activities (n=75; 27%). In addition, 17% (n=47) self-medicated with antibiotics and 24% (n=67) with oral corticosteroids. <bold>Conclusions:</bold> This multi-country survey highlights that actions taken by patients during exacerbations vary and may deviate from those recommended. This may contribute to delayed or undertreatment of these events and suggests a need for patient education on effective management of exacerbations.