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8% in 2011, 85.3% in 2018, p0.001). The number of physicians using inhaler steroid combinations as their first choice of treatment was found to be similar with the previous survey (p=0.909). According to the results of previous questionnaire, the application of COPD guidelines has decreased. The number of pulmonologists who declared they have no time for following or applying guidelines has profoundly increased since 2011. Despite the warnings of these guidelines, the use of inhaler steroid combination as a first treatment option in
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