OBJECTIVES: To assess the impact of the community pharmacy Spiriva New To Therapy (SNTT) compliance program on adherence and persistence METHODS: Patients presenting at participating community pharmacies with their first script for tiotropium were invited to participate in a pharmacist intervention involving two 10 minute protocol based coaching sessions, one month apart. Records were extracted of tiotropium scripts dispensed for all patients enrolled in the SNTT program over the following 12 months. Adherence was assessed by MPR over the first 6 months. Patients were considered to have ceased tiotropium if there was a three month gap in dispensed scripts. Time to cessation of tiotropium treatment was assessed using the Kaplan-Meier method.  The SNTT program was compared with persistence curves derived from a 10% random sample of tiotropium patients using the Australian prescription claims database (SPBS). RESULTS: A total  of 246 patients enrolled in the SNNT program;  48% completed Session #1, while 52% completed both Sessions. Over the first 6 months, SNTT program patients collected 5.2 tiotropium scripts indicating satisfactory adherence (MPR = 87% vs 55%); 2% of SNTT patients ceased tiotropium after the first prescription (SPBS=37%), while just 38% (63%) had stopped after 10 months. Persistence by patients completing two sessions was slightly better than those completing one. CONCLUSIONS: A pharmacist intervention involving two short protocol based coaching sessions significantly reduced the early cessation of tiotropium.  A total of 35% to 40% more SNTT program patients were persistent than the Australian SPBS population at 3-6 months. MPR was significantly improved