Some 24 million U.S. adults have chronic obstructive pulmonary disease (COPD), and about half are undiagnosed. Effective treatment of the progressive disease requires lifelong adherence to appropriate drug therapy regimens. However, patient adherence to the complicated therapies and physician adherence to prescribing guidelines are reported to be suboptimal. The authors analyzed Medstat 2007 commercial claim data to identify characteristics of COPD patients, and examined compliance patterns with established pharmacologic therapy guidelines. The analysis of treatment guidelines was accomplished through a comparison against the 2009 Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines.