OBJECTIVE:Accurate assessment of inhaler adherence is essential for optimizing treatment outcomes in patients with chronic obstructive pulmonary disease (COPD). This study aimed to evaluate the validity and reliability of the Turkish version of the Test of Adherence to Inhalers (TAI) in a multicentre COPD cohort. MATERIAL AND METHODS:A total of 277 patients were included. Sociodemographic characteristics and adherence status [assessed by the Turkish version of the Medication Adherence Report Scale-5 (MARS-5); İlaç Uyumunu Bildirim Ölçeği (İUBÖ)] were recorded. Construct validity was evaluated using confirmatory factor analysis (CFA), criterion validity was evaluated by agreement with İUBÖ using kappa statistics, and known-groups validity was evaluated by comparing the number of inhaler devices used. Reliability was assessed using Cronbach's alpha coefficients and item-total correlations. RESULTS:The mean age was 66.3±8.3 years, 81.9% of participants were male. Most patients (73.6%) used at least two inhaler devices, and 28.9% were classified as non-adherent according to İUBÖ. Based on TAI scores, 43.3% of patients had good adherence, 23.8% had intermediate adherence, and 32.9% had poor adherence. CFA supported the two-factor structure of the TAI (Tucker-Lewis Index: 0.965; Comparative Fit Index: 0.972; Root Mean Square Error of Approximation: 0.114). Criterion validity was demonstrated by good agreement between TAI and İUBÖ (kappa: 0.637, P < 0.001). Patients using more than one inhaler device were more likely to be non-adherent according to the TAI-10 (P = 0.02). Internal consistency was high for both the 10- and 12-item versions (Cronbach's alpha >0.90), with item-total correlations indicating adequate reliability. CONCLUSION:The Turkish version of the TAI is a valid and reliable tool for assessing inhaler adherence in patients with COPD and is suitable for both clinical practice and research settings in Türkiye.

Montelukast, a leukotriene receptor antagonist (LTRA) approved for the treatment of asthma and allergic rhinitis, is widely used, though real-world data on its application in asthma management remain limited. This registry-based study evaluated the use of montelukast in adult asthma patients, examining demographic and disease characteristics, asthma control status, asthma phenotypes, presence of atopy, and treatment regimens. Among 2053 patients analyzed, 61.76% (n = 1268; mean age: 46.2 ± 14.3 years), predominantly females (~76%), received montelukast. Montelukast users showed higher rates of allergic rhinitis (P < 0.001), hypersensitivity to nonsteroidal anti-inflammatory drugs (NSAIDs) (P = 0.008), and chronic rhinosinusitis (P = 0.008). Montelukast group also had higher atopy and total IgE levels and tended to be more eosinophilic. Montelukast was commonly preferred in allergic, eosinophilic, NSAID-exacerbated respiratory disease, and severe asthma phenotypes (P < 0.001). Patients receiving Steps 4 and 5 treatments are more likely to be prescribed montelukast (P < 0.001). Montelukast usage was higher among patients with uncontrolled asthma [ACT< 20 (OR:1.29, 95%CI:1.052–1.582, P = 0.014)]. In addition, logistic regression analyses identified the main factors associated with increased montelukast use as; female gender (OR:1.33, 95%CI:1.041–1.713, P = 0.02), presence of atopy (OR:1.46, 95%CI:1.157–1.864, P = 0.002), comorbid allergic rhinitis (OR:2.12, 95%CI:1.679–2.293, P < 0.001), and severe asthma (OR:2.18, 95%CI:1.712–2.784, P < 0.001). These findings reveal that montelukast use is prevalent among asthma patients, particularly in females, middle-aged adults, and those with comorbid allergic rhinitis, uncontrolled asthma, or specific asthma phenotypes, underscoring the factors that influence its prescription in asthma management.

Objective: The obese-asthma phenotype has gradually increased in the last few years. We aimed to assess the differences between obese and non-obese patients with asthma. Methods: This research is a subanalysis of the Turkish Adult Asthma Registry (TAAR). Clinical presentation, disease control, severity, and demographics of obese and non-obese (normal-weight, overweight) patients were compared. Results: The obesity rate in TAAR was 32.2% (n=619/1919; 18-83years; 527F/92 M). Patients with asthma and obesity had higher rates of childhood obesity, longer symptom duration, later onset of asthma, and more severe asthma. These patients were more likely to be female, older, less educated, and live in rural areas. Patients with obesity had more scheduled visits and emergency visits compared with non-obese patients, but similar asthma control, oral corticosteroid use, hospitalizations, intensive care unit admissions, and unscheduled visits. They also had a higher frequency of T2-high but lower frequency of possible T2-low phenotypes compared with normal-weight asthmatics. The risk of severe asthma in patients with obesity was 6.04 times higher for allergic than non-allergic patients and 3.58 times higher for the T2-high phenotype than for possible T2-low phenotypes. A one-unit increase in the asthma control test reduced the risk of severe asthma by 22%. Conclusions: A good definition of this phenotype is important to ensure that appropriate treatment strategies are implemented to achieve the control goal. We also believe that prevention of childhood obesity is an effective and pivotal strategy to achieve the goal of asthma control.

Objective:The Rome classification was introduced to assess the severity of acute exacerbation (AE) of chronic obstructive pulmonary disease (COPD) based on easily measurable variables. However, its validation for global use has not yet reached a sufficient level. This study aims to evaluate the validity of the Rome criteria in determining the severity and prognosis of COPD AE in Turkey. Methods:This multicenter study, conducted for the first time in Turkey and for the fourth time worldwide, included 750 patients diagnosed with AE-COPD who presented to emergency departments and outpatient clinics. According to the Rome criteria, patients were classified into three groups: mild, moderate, and severe AE-COPD. Results:The study included 99 (13.2%) patients in the mild, 479 (63.9%) in the moderate, and 172 (22.9%) in the severe group. Emergency visits, hospitalizations, and ICU admissions in the past year were more frequent in the moderate and severe groups (p < 0.001 for all comparisons). Regarding outcomes of emergency or outpatient visits, most mild exacerbation cases were discharged (p < 0.001), while most moderate and severe exacerbations required hospitalization (p < 0.001). Compared to the moderate group, the severe exacerbation group had a higher risk of ICU admission (p < 0.001), NIV (p < 0.001), IMV (p < 0.001), in-hospital mortality (p < 0.001), and 30-day mortality (p = 0.015). No significant differences were found in 90-day mortality or 30 and 90-day readmission rates (p = 0.258, p = 0.712, p = 0.681, respectively). Survival analysis revealed no significant difference between the moderate and severe groups (p = 0.764). Conclusion:The findings suggest that the Rome criteria can be successfully used to assess exacerbation severity in AE-COPD patients presenting to secondary and tertiary care hospitals in Turkey.

The COVID-19 pandemic and related public health restrictions have substantially altered healthcare access and delivery, particularly for patients with chronic conditions such as chronic obstructive pulmonary disease (COPD). This study aimed to evaluate the impact of the COVID-19 pandemic and lockdown measures on COPD-related symptoms and hospital admissions, and to compare these outcomes with the pre-pandemic period. This multicenter cross-sectional study was conducted between July 2021 and February 2022 across ten tertiary pulmonary outpatient clinics in Turkey. A total of 347 COPD patients were included. Data on demographics, spirometry, symptom progression, medication access, COVID-19 history, and hospital admissions were collected via structured questionnaire and medical records. Pandemic-related outcomes were compared with data from the pre-pandemic year (March 2019–March 2020). Additional multivariable regression analyses were performed to identify predictors of hospital admission and COVID-19-related hospitalization. The mean number of hospital admissions significantly decreased during the pandemic compared to the pre-pandemic period (p < 0.001), while patient-reported respiratory symptoms increased over time. Hospital admissions were lowest during the first pandemic period, when restrictions were most intense. Regression analyses showed that lower FEV₁, advanced GOLD stage, and inhaled corticosteroid (ICS) use were independently associated with increased hospital admissions. COVID-19 was diagnosed in 21.1

OBJECTIVE:Risk factors associated with asthma symptom control is crucial for disease management. This study aimed to determine the risk factors of patients with uncontrolled asthma and to examine the relationship with their geographical patterns. METHODS:This cross-sectional study was conducted at 36 centers across Turkey. Future risk factors (FRFs) such as exposure to triggers/allergens and inadequate or poor inhalation technique, etc., were identified based on the Global Initiative for Asthma (GINA) guidelines. The associations between FRFs and demographic and clinical characteristics, geographical regions, and levels of asthma control were analyzed. RESULTS:The study included 2,053 adult asthma patients. At least one FRF was identified in 1576(76.8%) patients. The most common FRFs were exposure to allergens/triggers (n: 664; 32.3%), impaired asthma symptom control (n: 540; 26.3%), and eosinophilia (n: 526; 25.6%). Regarding regional differences, the most prevalent FRFs in the Marmara region were exposure to allergens/triggers and frequent use of short-acting beta-2 agonists (>3 boxes/year). In contrast, eosinophilia was more common in the Southeastern region, while inadequate or poor inhalation technique, noncompliance with treatment, and psychosocial or socioeconomic problems were more frequently observed in the Eastern Anatolia region. Asthma control was achieved in 79.5% of patients without any FRFs; however, this rate decreased significantly to 25% among patients with more than four FRFs. CONCLUSIONS:This study demonstrates that FRFs in asthma vary according to demographic and disease characteristics, as well as geographical distribution. An increased number of FRFs was associated with asthma control. However, an individualized approach remains essential for achieving optimal asthma management.

AbstractBackgroundAsthma is one of the most common causes of chronic respiratory disease, and countries with low socioeconomic status have both a high prevalence of asthma and asthma‐related death.ObjectiveIn this study, we aimed to determine socioeconomic levels of asthmatic patients according to a national database and investigate the effects of social markers on disease control in our region.MethodsThis is an analysis of data from 2053 adult asthma patients from a multicentre chart study in Turkey. Socioeconomic status (SES) data were collected from questionnaires and this form was sent to the patients via e‐mail. Parameters related to social status and poor disease control were analyzed.ResultsIlliteracy (OR:2.687 [95% CI: 1.235–5.848]; p = 0.013) and lower household income (OR:1,76 [95% CI: 1.002–3.09]; p = 0.049) were found as independent risk factors for hospitalization in the multivariate logistic regression analysis. Therewithal, being aged between 40 and 60 (OR: 1.435 [95% CI: 1.074–1.917]; p = 0.015), illiteracy (OR: 2.188 [95% CI: 1.262–3.795]; p = 0.005) and being employed (OR: 1.466 [95% CI: 1.085–1.847]; p = 0.011) were considered as independent risk factors for systemic corticosteroid use at least 3 days within last 1 year.ConclusionAs a result of our national database, education level, household income and working status briefly socioeconomic status have impacts on asthma control. Identification of social markers in asthma and better recognition of risk factors based on the population gives us clues to provide better asthma control in the future.

Objectives It is aimed to assess how physicians use chest imaging in asthma and the relationship between the pathological findings and related disease characteristics in the radiological imaging of asthmatic patients. Background The daily practice of imaging and its contribution to the management of asthma are not well defined. It is common to use radiological imaging to investigate pathologies that cause respiratory symptoms and to evaluate differential diagnoses in asthma patients. In this study, as a subanalysis of the Turkish Adult Asthma Registry, radiological findings and outcomes of asthmatic patients were examined. Methods Between March 2018 and March 2022, the data of asthma patients in 36 secondary and tertiary health care centers was recorded using a web-based application. Patients with chest X-ray, computed thorax tomography, and paranasal sinus tomography data in the asthma database were statistically evaluated for sub-analysis. Results The study included 2053 patients. Chest X-rays were taken in the majority of the cases (n:1739; 84.7%). Computed thorax tomography was performed in 869 (42.3%) patients and paranasal sinus tomography in 388 (18.9%) patients. The most common pathological findings on chest X-rays of asthmatic patients were increased bronchovascular branching and dirty lung appearance, whereas they were linear atelectasis, and bronchial wall thickening on computed thorax tomography bronchiectasis. Soft tissue in the sinuses and nasal polyps were the most common pathological findings in paranasal sinus tomography. Pathological findings were much more common in the radiological evaluations of patients with eosinophilic and allergic phenotypes and in patients with severe asthma. Conclusion The radiological findings of asthma vary depending on the phenotype and severity of the disease. Patients with asthma, particularly those in the high-risk group, should be evaluated from a radiological perspective.

INTRODUCTION:Considerable overlaps exist between asthma phenotypes and the clinical significance of these overlaps remains undetermined. The objective of this study is to analyze the characteristics of asthma overlap phenotypes using data from the Turkish Adult Asthma Registry (TAAR). METHODS:This cross-sectional registry study included 2053 adult patients (74.8% female) with asthma. RESULTS:Overall, 39.3% (n = 697) had allergic-eosinophilic (AE), 26.0% (n = 461) had allergic-non-eosinophilic (ANE), 21.3% (n = 377) had non-allergic-eosinophilic (NAE), and 13.4% (n = 237) had non-allergic-non-eosinophilic (NANE) asthma. Severe asthma exacerbations and emergency department (ED) visits were more frequent in the AE (28.3%, 31.2%, respectively) and NAE groups (36.0%, 34.0%, respectively) than in the ANE (14.3%, 20.6%, respectively) and NANE groups (12.6%, 16.7%, respectively) (p < 0.001). FEV1 values were significantly lower in the AE group than in the ANE and NANE groups (p < 0.001, p = 0.048, respectively) and in the NAE group than in the ANE group (p < 0.001). Risk factors for poor asthma control included living in rural areas, asthma-related ED visits, FEV1 < 60% in the NAE; being overweight, chronic rhinosinusitis, oral corticosteroids use, age < 40 years in the NANE; FEV1 < 80% in the AE; and severe asthma exacerbations, ED visits for AE and ANE groups. CONCLUSION:The considerable overlap between allergic and eosinophilic asthma phenotypes has clinical implications as increased rates of asthma exacerbations and healthcare utilization. The clinical heterogeneity among asthma phenotypes based on a single biomarker highlights the importance of multidimensional asthma phenotyping.

Exacerbations of chronic obstructive pulmonary disease (COPD) are associated with loss of lung function, poor quality of life, loss of exercise capacity, risk of serious cardiovascular events, hospitalization, and death. However, patients underreport exacerbations, and evidence suggests that unreported exacerbations have similar negative health implications for patients as those that are reported. Whilst there is guidance for physicians to identify patients who are at risk of exacerbations, they do not help patients recognise and report them. Newly developed tools, such as the COPD Exacerbation Recognition Tool (CERT) have been designed to achieve this objective. This review focuses on the underreporting of COPD exacerbations by patients, the factors associated with this, the consequences of underreporting, and potential solutions.

Chronic obstructive pulmonary disease (COPD) frequently results in hospital readmission and contributes to increased morbidity and mortality. This multicenter prospective study aimed to identify factors that increase the risk of readmission within 30 to 90 days of severe COPD exacerbation. A total of 415 patients admitted to the emergency department (ED) or general pulmonology ward after discharge due to severe exacerbations from 13 tertiary centers in Turkey were included. Of the participants, 346 (83.4%) were male and 69 (16.6%) were female, with an average age of 69.0 +/- 9.1 years. Readmissions within 30 and 90 days after the initial hospitalization occurred in 176 (42.4%) and 191 (46%) patients, respectively. Prospective data collection focused on exacerbation severity, disease severity, and the utility of initial admissions. Factors for 30 to 90 day readmission were analyzed using univariate and multivariate regression models. A 30-day readmission correlated significantly with Hospital Anxiety Depression Scale scores above 16 [odds ratio [OR] 95% confidence intervals [CI]: 1.9 (1.1-3.6); P = .042], severe exacerbation history in the previous year [OR 95% CI: 1.7 (1.1-2.9); P = .038], hospital-acquired pneumonia [OR 95% CI: 1.9 (1-4.1); P = .049)], and frequent antibiotic use in the previous year [OR 95% CI: 1.8 (1.2-2.7); P = .007]. Risk factors for 90-day readmissions included: Grades 3 to 4 tricuspid regurgitation [OR 95% CI: 2.2 (1.1-4.4); P = .024], 2 or more moderate COPD exacerbations [OR 95% CI: 1.9 (1.2-3.1); P = .010], severe exacerbation history in the previous year [OR 95% CI: 2.5 (1.5-4.2); P = .001], immunosuppression [OR 95% CI: 2.7 (1.2-5.7); P = .013], frequent antibiotic use the previous year [OR 95% CI: 1.5 (1-2.4); P = .048], hospitalization via the ED [OR 95% CI: 1.6 (1.1-2.6); P = .028]. To mitigate complications and readmissions, patients with a history of frequent severe COPD exacerbations, high anxiety and depression scores, frequent antibiotic requirements, immunosuppression, tricuspid regurgitation, hospital-acquired pneumonia, and those admitted to the ED should be prioritized for remote monitoring after initial discharge.

Exacerbation is an independent risk factor for chronic obstructive pulmonary disease (COPD)-related morbidity and mortality. Despite optimal care, there may be risk factors that lead to difficulties in managing exacerbations that may be associated with prolongation of length of hospital stay (LOS). This is a multicenter prospective observational study of COPD patients hospitalized with exacerbations. Prolonged LOS was calculated according to the 50th percentile and defined as ≥ 9 days. Potentially predicting factors of LOS were stratified into 4 pillars as patient-related, disease and exacerbation-related, treatment-related and, hospital utility-related. These categories were systematically documented throughout the duration of the hospitalization. A total of 434 patients, 361 males and 73 females, with a mean age of 69.2 ± 9.3 years, were included in the study. Variables of each pillar were tested with univariate analysis to identify potential risk factors for prolonged LOS. Subsequently significant factors excluding factors associated with hospital utility were tested with multivariate logistic regression analysis for detecting potential associated factors for difficult-to-manage COPD exacerbation. Biomass exposure, past history of non-invasive mechanical ventilation (NIMV), low bicarbonate levels at admission, antibiotic switching, need for theophylline, increasing oxygen requirement, need for in-hospital non-invasive mechanical ventilation, nutritional support and physiotherapy were found as defining factors. The DiMECO study can help to identify COPD exacerbators who are at risk for prolonged hospitalizations that may associate with difficult-to-manage COPD exacerbations. Difficult to manage COPD exacerbation may serve as a provocative framework, underscoring the necessity for a better understanding of the multifaceted approaches to the management of COPD exacerbations. This conceptualization warrants further investigation across diverse clinical settings to validate its applicability and efficacy.

Introduction: Patients with asthma-chronic obstructive pulmonary disease (COPD) overlap (ACO) have a greater disease burden than those with COPD or asthma alone. In this study, it was aimed to determine the prevalence, risk factors, and clinical features of ACO because there are limited national data in T & uuml;rkiye. Materials and Methods: The study was conducted in a cross-sectional design in nine tertiary-care hospitals. The patients followed with a diagnosis of asthma or COPD for at least one year were enrolled in the study. The frequency of ACO and the characteristics of the patients were evaluated in the asthma and COPD groups Results: The study included 408 subjects (F/M= 205/203, mean age= 56.24 +/- 11.85 years). The overall prevalence of ACO in both groups was 20.8% (n= 85). The frequency was higher in the COPD group than in the asthma group (n= 55; 33.3% vs. n= 22; 9.8%), respectively (p= 0.001). Patients with ACO had similarities to patients with COPD in terms of advanced age, sex, smoking, exposure to biomass during childhood, being born in rural areas, and radio-logic features. Characteristics such as a history of childhood asthma and allergic rhinitis, presence of chronic sinusitis, NSAID hypersensitivity, atopy, and high eosinophil counts were similar to those of patients with asthma (p< 0.001). The annual decline in FEV1 was more prominent in the ACO group (mean= -250 mL) than in the asthma (mean change= -60 mL) and COPD (mean change= -230 mL) groups (p= 0.003). Conclusion: This study showed that ACO was common among patients with asthma and COPD in tertiary care clinics in our country. ACO should be considered in patients with asthma and COPD who exhibit the above mentioned symptoms

IntroductionNational data on asthma characteristics and the factors associated with uncontrolled asthma seem to be necessary for every country. For this purpose, we developed the Turkish Adult Asthma Registry for patients with asthma aiming to take a snapshot of our patients, thereby assigning the unmet needs and niche areas of intervention.MethodsCase entries were performed between March 2018 and March 2022. A web-based application was used to record data. Study outcomes were demographic features, disease characteristics, asthma control levels, and phenotypes.ResultsThe registry included 2053 patients from 36 study centers in Turkey. Female subjects dominated the group (n = 1535, 74.8%). The majority of the patients had allergic (n = 1158, 65.3%) and eosinophilic (n = 1174, 57.2%) asthma. Six hundred nineteen (32.2%) of the patients had obese asthma. Severe asthma existed in 670 (32.6%) patients. Majority of cases were on step 3-5 treatment (n: 1525; 88.1%). Uncontrolled asthma was associated with low educational level, severe asthma attacks in the last year, low FEV1, existence of chronic rhinosinusitis and living in particular regions.ConclusionThe picture of this registry showed a dominancy of middle-aged obese women with moderate-to-severe asthma. We also determined particular strategic targets such as low educational level, severe asthma attacks, low FEV1, and chronic rhinosinusitis to decrease uncontrolled asthma in our country. Moreover, some regional strategies may also be needed as uncontrolled asthma is higher in certain regions. We believe that these data will guide authorities to reestablish national asthma programs to improve asthma service delivery.

Objective: To estimate the economic burden and key cost drivers of managing exacerbated and hospitalized chronic obstructive pulmonary disease (COPD) patients in Türkiye. Material and Methods: This cost of illness study was based on an estimation of per patient annual direct medical costs for the management of exacerbated and hospitalized COPD patients in Türkiye from a payer perspective. The average per patient direct medical cost was calculated based on cost items related to outpatient visits, diagnostic laboratory and radiological tests, hospitalizations and interventions, training and rehabilitation, drug treatment and equipment, drug-related adverse events, and co-morbidities/complications. Results: Based on average annual per patient costs calculated for outpatient admission ($88.5), laboratory and radiological tests ($68.6), hospitalizations and interventions/training/rehabilitation ($1,181.3), drug treatment/equipment ($1,088.0), co-morbidities/complications ($1,291.7) and drug related adverse events ($11.8) cost items, per patient annual direct medical cost related to the management of exacerbated and hospitalized COPD patients was calculated to be $3,729.9 from the payer perspective. Co-morbidities/complications (34.6%), hospitalizations/interventions (31.7%) and drug treatment/equipment (29.2%) were the key cost driver. Results: In conclusion, our findings indicate that managing exacerbated and hospitalized COPD patients pose a considerable burden to health economics in Türkiye, with co-morbidities and hospitalizations estimated as the main cost drivers. Our findings emphasize the need for cost-effective prevention strategies and the likelihood of potential cost-savings by timely recognition and proper management of co-morbidities and by better disease control with reduced frequency of exacerbations and hospitalizations.

Background/aim: Our aim is to determine the caregiver burden of chronic obstructive lung disease (COPD) patient's caregivers, and to determine whether there is a workday loss. Materials and methods: 252 COPD patients and their caregivers were included. Disease information of the patients were recorded and a questionnaire was applied. Socio-demographic characteristics of the caregivers were recorded and a questionnaire consisting of 24 questions including COPD disease, treatment and loss of working days, and the Zarit Scale were used. Results: 128(50.8%) of the patients according to GOLD were group-D, 97(38.5%) of the patient's relatives were working, 62(24.7%) were not able to go to work for 1-14 days, and 125(57.1%) spent outside the home from 1-14 nights, because those accompanied to patients. In univariate analysis were detected modified medical research council (mMRC) (p < 0.001), CAT (p < 0.001), the number of comorbidities of patients (p = 0.027), forced expiratory volume in 1 FEV1cc (p = 0.009), FEV1% (p < 0.001), the presence of long term oxygen therapy (LTOT), and the number of comorbidities of the patient's relatives (p = 0.06) increased the care load. In multiple linear regression analysis, age (p = 0.03), COPD assessment test (CAT) score (p = 0.001), FEV1% (

Dyspnea is the most important symptom of chronic obstructive pulmonary disease (COPD). Training and exercise in symptom management improve the physical and psychological condition of patients, increase their compliance with treatment and quality of life. In this study, it was aimed to determine the effect of upper extremity exercises performed by a specialist nurse without using extra tools on dyspnea. The study was conducted with 78 patients with COPD, including 39 exercise and 39 control group. The patients in exercise group carried out upper extremity exercise for 30 minutes, 3 times a week throughout 8 weeks and the clinical course of the control group was not interfered. At the end of 8 weeks, patients were compared in terms of their symptom scores and scale point averages. Patient Identification Form, Saint George Respiratory Questionnaire, Medical Research Council, Modified Borg Scale, COPD Evaluation Test, 6minute walk test distance criteria and oxygen saturation measurements were used in the collection of data. It was discovered that of the participants involved in the study, 92.3% of cases were males, the average age in exercise group was 58.00±5.94 and it was 55.87±8.09 in the control group. In the 8th week, it was observed that the distance increased for the majority of patients in exercise group in 6-minute walk and with regard to COPD evaluation test, Medical Research Council, Modified Borg Scale dyspnea score average reduced. Upper extremity exercises that had been regularly applied to patients with COPD for 8 weeks under the supervision of attending nurse were observed to be effective in elevating patients’ life quality.