The trainings for inhaler use and discussion of the importance of basis therapy taking can improve adherence to chronic obstructive pulmonary disease (COPD) treatment significantly. However, the influence of war, including financial difficulties, can reduce this parameter. The degree of this adherence decrease is unclear.

The aim of the study was to detect what level of adherence can be maintain during the war.

Methods. The 132 patients with severe and very severe COPD were enrolled into study. Before the participation in this study they completed the program for increase of the adherence to COPD treatment. They did not move to other city or region during the war.

These patients visited medical outpatient institution every 3 months from early-March 2022 until mid-January 2023.

During each of the 3 visits it was reminded to take basis therapy regularly and the training to use the inhaler correctly was conducted to them.

The T-test for independent and dependent samples was used for the comparison of parameters average values and reliability assessment of intergroup differences.

Results. During the 1 year of adherence improve program the level of it raised from 47.54 2.41 % to 77.34 3.52 % (p < 0.001). At the third visit during the war the adherence had a tendency to decrease from 77.34 3.52 % to 74.13 5.76 %. However, this tendency was beyond of statistical significance.

Conclusions. Relatively rare visits to physicians with actions for proper adherence to COPD treatment can maintain it at the same level despite of war-associated issues. It is still unclear whether these results can be extrapolated to the patients that became refugees.