[Health services research among registered pulmonologists: experiences and assessments of COPD therapy in German practice (DELFIN COPD 2)].

Chronic obstructive pulmonary disease (COPD) is one of the leading causes of death worldwide. In recent years, both clinical guidelines and therapeutic options have evolved significantly. The aim of the DELFIN COPD 2 study (Deutsche Expert*innenbefragung: Leitlinien, Fakten, Informationen, Nutzereinschätzungen zur COPD 2), was to provide an up-to-date overview of outpatient care for COPD patients led by pulmonologists in Germany. As part of a nationwide cross-sectional survey, 377 office-based pulmonologists were interviewed using a standardised questionnaire between March and October 2024. Data were analysed descriptively.The results show that fixed combinations of long-acting muscarinic antagonists (LAMA) and long-acting beta-agonists (LABA) are commonly used as the preferred initial therapy in clinical practice. Many pulmonologists consider twice-daily inhalation beneficial, particularly in cases of evening and night-time symptoms. The majority of respondents observe the circadian pattern of COPD symptoms. They attribute this to a combination of physiological changes, waning medication effects and insufficient nocturnal ventilation. International recommendations, especially those from the Global Initiative for Chronic Obstructive Lung Disease (GOLD), play a key role in therapeutic decision-making, whereas economic factors, such as rebate contracts with health insurance providers, are less influential. Correct inhaler use is typically demonstrated by practice staff. Two-thirds of respondents offer smoking cessation support and half use digital tools to assist with patient care.DELFIN COPD 2 highlights the typical challenges of managing COPD in an outpatient setting, such as underutilisation of digital support options. Key elements of future COPD care include consistent smoking cessation efforts, personalised treatment strategies and greater integration of digital health tools.