• Difference between modified Medical Research Council score at baseline (visit 1) and mMRC score after end of observation [ Time Frame: 12 weeks ]
  The modified Medical Research Council (mMRC) scale is a 5-point (0-4) scale based on the severity of dyspnoea
• Difference between CAT score at baseline (visit 1) and CATTM score after end after end of observation [ Time Frame: 12 weeks ]
  The COPD Assessment Test (CAT TM) consists of eight items -cough, phlegm, chest tightness, breathlessness when going up hills/stairs, activity limitations at home, confidence leaving home, sleep and energy. CAT TM is a trademark.

• patient's general condition according to the Physician's Global Evaluation (PGE) score at baseline and end of the observation period [ Time Frame: upto 12 weeks ]
  PGE evaluates the general condition of the patient on an 8-point ordinal scale from 1 (very poor) to 8 (excellent) before and approx. 12 weeks after treatment initiation
• patient satisfaction with inhaler and therapy at end of observation period according to a seven-point ordinal scale (ranging from very dissatisfied to very satisfied as documented in non-interventional BI studies [ Time Frame: upto 12 weeks ]
  A7-item satisfaction scale with divisions from very dissatisfied to very satisfied to measure patient satisfaction with inhaler use, is a Likert-scale without validation status for the intended use
• proportion of responders with mMRC ≥1 and the proportion of responders with CAT ≥2 [ Time Frame: upto 12 weeks ]

• Drug: Long-acting muscarinic antagonist+ Long-acting beta2 adrenoceptor agonist
  LAMA+LABA
  Other Name: Spiolto® Respimat®
• Drug: Triple combination of Free or fixed Long-acting muscarinic antagonist+ Long-acting beta2 adrenoceptor agonist + inhalative corticosteroids
  (LAMA+LABA+ Inhalative Corticosteroids (ICS)
  Other Name: LAMA+LABA+ Inhalative Corticosteroids (ICS)

Inclusion Criteria:

Patients can be included if all of the following criteria are met:

• Diagnosis of COPD
• Symptomatic (with regard to dyspnea (mMRC Dyspnea score ≥1) AND with regard to symptoms (CAT Score ≥10) at the same time)
• Patients on LABA/ICS maintenance therapy who are switched to Spiolto® Respimat® in the new reusable inhaler or a free/fixed triple combination of LABA + LAMA + ICS at Visit 1 at the discretion of the treating physician.
• Adults who are contractually capable and mentally able to understand and follow the instructions of the study personnel
• Male or female
• Patients aged ≥40 years of age
• Written informed consent prior to study participation
• The patient is willing and able to follow the procedures outlined in the protocol

Exclusion Criteria:

• Patients with contraindications acc. to SmPC
• Patients not on LABA/ICS maintenance treatment at visit 1, e.g., mono or dual bronchodilation only, ICS only, or a triple combination of LAMA + LABA + ICS (either as a fixed combination product or as separate components)
• Lack of informed consent
• Pregnant and/or lactating females
• Acute exacerbation of COPD (within 4 weeks prior to Visit 1)
• Frequently exacerbating patients, i. e. patients with ≥2 moderate exacerbations within the last 12 months or ≥1 exacerbation leading to hospitalization within the last 12 months
• Acute respiratory failure (pH <7,35 and/ or respiratory rate >30/min within 3 months prior to Visit 1)
• History or current diagnosis of asthma
• History or current diagnosis of asthma-COPD overlap
• History or current diagnosis of allergic rhinitis within the last 5 years
• History or current diagnosis of lung cancer within the last 5 years
• Participation in a parallel interventional clinical trial
• mild exacerbation: additional use of short-acting bronchodilators and treated by the patient without consulting a physician
• moderate exacerbation: treatment includes medical prescription of a systemic corticosteroid and/or antibiotic
• severe exacerbation: exacerbation leading to hospitalization