SERPINA1 and chronic obstructive pulmonary disease: In addition, during this period between the two audits, several updates to good clinical practice guidelines [9] and strategic documents on COPD management [10,11] were published, with an extensive dissemination plan for good clinical practice recommendations, aiming to improve the quality of care, with special emphasis on the most deficient areas based on the results of the first audit, such as the request for AAT levels in COPD.