care and office based chest medicine clinics. A convenience sample of 500 was selected. Results We report the characteristics of the first 250 COPD patients from our ongoing 500 patient survey. Basic demographics 55% Male, 45% Female. Mean age patients 68 ± 12 yrs, all patients were previous smokers with 56 ± 10 pkt/yrs smoking history. 34% remain current smokers. Mean FEV1 48% ± 10%, Mean FEV1/FVC ratio 49% ± 10. Median mMRC dyspnea score 2. Mean CAT score 18 ± 10 (Range 0-38). GOLD Stage

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... ification 13% GOLD Stage A, 67% GOLD Stage B, 1% GOLD Stage C and 19% GOLD Stage D. Current treatment LAMA (long-acting muscarinic antagonist) was prescribed to over 90% of all patients in groups B, C and D whereas monotherapy with LABA (long acting beta-agonist) or dual bronchodilation with LABA/LAMA therapy was prescribed to less than 5%. There was significant overtreatment with ICS/LABA in all categories with high dose ICS (inhaled corticosteroid) being preferred. 20% of patients in GOLD Stage A where receiving Triple therapy (LAMA + ICS/LABA) and a further 20% where receiving monotherapy with ICS/LABA, yet had no history of exacerbations. 30% of patients in GOLD Stage B where receiving Triple therapy (LAMA + ICS/LABA) yet had no history of exacerbations. Conclusion Current Canadian Guidelines and the GOLD strategy focus on symptom relief and striving to prevent exacerbations with step-wise prescription of short and long-acting bronchodilators with individual or combinations of LAMA, LABA, LAMA/LABA or ICS/LABA inhalers. Patients in GOLD Group C are rare. Current prescription choices in our survey does not reflect current evidence or guidelines. We report a heavy reliance on ICS/LABA along with over prescription of triple therapy at all stages of disease.