ORIGINAL RESEARCH Understanding Practice Patterns of COPD: A Survey of Physicians in Nepal, Sri Lanka and Malaysia Ramesh Chokhani . Abdul Razak Muttalif . Kirthi Gunasekera . Aniruddha Mukhopadhyay . Vaibhav Gaur . Jaideep Gogtay Received: February 7, 2021 / Accepted: March 12, 2021 / Published online: April 15, 2021 Ó The Author(s) 2021 ABSTRACT Introduction: There is much recent data from Nepal, Sri Lanka and Malaysia that can help us understand the practice patterns of physicians regarding the diagnosis and management of chronic obstructive pulmonary disease (COPD) in these countries. We conducted this survey to understand the practice patterns of physicians related to the diagnosis and management of COPD in these three countries. Methods: This questionnaire-based, observa- tional, multicentre, cross-sectional survey was carried out with 438 randomly selected physi- cians consulting COPD patients. Results: In the survey, 73.29% of the physi- cians consulted at least five COPD patients daily (all patients [ 40 years of age). 31.14% of the COPD patients visiting their doctors were women. Among physicians, 95.12% reported that at least 70% of their patients were smokers. 34.18% of the physicians did not routinely use spirometry to diagnose COPD. Most physicians preferred a short-acting b 2 -agonist (SABA) (28.19%) in the Global Initiative for Chronic Obstructive Lung Disease (GOLD) Group-A and long-acting muscarinic receptor antagonist plus long-acting b 2 -agonist/inhaled corticosteroids (LAMA ? LABA/ICS) in both the GOLD Group- C (39.86%) and Group-D (72.89%) patients. A significant number (40.67%) of physicians pre- ferred LABA/LAMA for their GOLD Group-B patients. A pressurised metered dose inhaler (pMDI) with or without spacer was the most preferred device. Only 23.67% of the physicians believed that at least 70% of their patients had good adherence ( [ 80%) to therapy. Up to 54.42% of the physicians prescribed inhalation therapy to every COPD patient. Also, 39.95% of the physicians evaluated their patients’ inhala- tion technique on every visit. Up to 52.67% of the physicians advised home nebulisation to [ 10% of patients, with nebulised SABA/short- acting muscarinic receptor antagonist (SAMA) being the most preferred management choice. Most physicians offered smoking cessation advice (94.16%) and/or vaccinations (74.30%) as non-pharmacological management, whereas pulmonary rehabilitation was offered by a smaller number of physicians. Cost of therapy and poor technique were the most common Supplementary Information The online version contains supplementary material available at https:// doi.org/10.1007/s41030-021-00153-w. R. Chokhani Norvic International Hospital, Kathmandu, Nepal A. R. Muttalif MAHSA University, Selangor, Malaysia K. Gunasekera Nawaloka Hospital, Colombo, Sri Lanka A. Mukhopadhyay Á V. Gaur (&) Á J. Gogtay Global Medical Affairs, Cipla Ltd, Mumbai, India e-mail: vaibhav.gaur@cipla.com Pulm Ther (2021) 7:251–265 https://doi.org/10.1007/s41030-021-00153-w