Introduction: COPD exacerbations are associated with lung function decline,lower quality of life and increased mortality, and can be prevented by pharmacologicaltreatment and rehabilitation. The aim of this study was to explore if theorganization of the COPD care in primary health care centres influences the riskfor new exacerbations.Methods: A clinical population of 775 COPD patients was randomly selected from70 Swedish primary health care centres (PHCCs). Data on COPD exacerbationsand following preventive measures were obtained from medical record review.Cox regression analyses were used to estimate the risk of a new exacerbation withadjustment for age and sex.Results: During a study period of four years 458 patients had an exacerbation,and of these 278 patients (61%) had a second exacerbation during the follow-upperiod. Patients with a scheduled extra visit to an asthma/COPD nurse followingan exacerbation had a decreased risk of a new exacerbation compared to patientswith no extra follow-up besides regularly scheduled visits (adjusted hazard ratio(95% CI) 0.54 (0.32 to 0.93), p=0.026).Conclusion: Scheduling an extra visit to an asthma/COPD nurse following aCOPD exacerbation decreased the risk of reexacerbations in primary care patients.We conclude that a close cooperation between professional categories is importantin the prevention of COPD exacerbations in primary care.