Objective To understand the factors influencing the inhaled medications in patients with frequent acute exacerbations of chronic obstructive pulmonary disease （COPD）, and to provide a basis for the development of appropriate inhaled medication adherence management programs.Methods Based on the Capability, Opportunity, Motivation-Behavior （COM-B） model, a descriptive qualitative study was conducted.Using purposive sampling method, 17 patients with frequent acute exacerbations of COPD who were admitted to Nanfang Hospital of Southern Medical University between November 2023 and January 2024 were selected for semi-structured interviews.Directed content analysis was employed to analyze the data.Results A total of 3 themes and 10 sub-themes were extracted, which were competency factors (inhaled medication use skills, disease and medication-related perceptions, and medication self-management), opportunity factors (family support, insufficient accessibility to medical care, and financial burden), and motivational factors (treatment self-efficacy, acute exacerbation experience, perceived treatment benefits, and disease stigmatization). Conclusion COPD patients with frequent acute exacerbations face multiple challenges in the use of inhaled medications, and should be comprehensively assessed for the capability, opportunity, and motivational factors affecting patient adherence to inhaled medications, with an emphasis on providing education and training to enhance patients′ skills and literacy, as well as creating a favorable environment of external resources to enhance their adherence to inhaled medication adherence.