Pharmacists worked one day per week in five practices for three months liaising closely with practice respiratory nurses and the lead respiratory GP. GOLD criteria and local COPD guidelines were used to identify patients potentially suitable for step-down and/or stop of inhaled corticosteroids. These patients were invited to attend the practice for a consultation with a respiratory nurse or pharmacist, bringing all inhalers, including excess, with them. Where appropriate, step-down of inhaled corticosteroid dose was recommended and patients were followed up to ensure they were managing the new regime without experiencing any problems