The data collection for this study differs from other registries in that data going into the AL1TER Registry is being collected by homecare agency personnel (i.e., pharmacists and nurses). The data will be collected from standard Coram homecare forms. AL1TER Registry data will be entered into Coram's standard patient database and processed in the same manner as for non-registry patients but will be extracted in a systematic fashion for incorporation into the AL1TER Registry. Data collected from the St. George Respiratory Questionnaire (SGRQ), and the Life Quality index Questionnaire (LQIQ), and subject medical chart review may also be entered into the AL1TER Registry database. All data will be de-identified for use when reporting results of the database.