Background: COPD is a chronic condition requiring care from a multidisciplinary team in which pharmacists play an important role. Aim: We aimed to evaluate the impact of structured pharmacist-patient counseling on patient’s knowledge, attitudes about medicines and the impact of COPD on patients’ health status. Methods: A prospective study was conducted in ten community pharmacies. Patients were counseled using detailed approach after completing validated questionnaires. The patients returned to a pharmacy for a follow-up after three months. Four validated questionnaires have been used to assess different aspects of patient’s knowledge about the disease, their attitudes about medicines and the impact of disease on patients’ health status: COPD Assessment Test (CAT), Modified Medical Research Council Dyspnea Scale (mMRC), Bristol COPD Knowledge Questionnaire (BCKQ), and The Beliefs about Medicines Questionnaire (BMQ). Results: Pharmacists recruited 83 COPD patients, from which 73 patients attended a follow-up visit. Before pharmacist intervention, the CAT median score was 20. After counseling, the CAT score decreased to 18 (p<0.05). The highest improvement in patient’s knowledge was observed for inhaled bronchodilators (28.2%), vaccination (25.8%), oral steroids (24.4%), and smoking (24.2%). The median score for necessity increased, whereas the harm and concern median scores considerably decreased (p<0.05). Conclusion: The results showed significant improvements in all aspects covered throughout pharmacist-patient counseling. Based on our results, proactive role of the pharmacist in the care of COPD patients may be beneficial to patients, to physicians and to healthcare: improving care, alleviating the strain on overloaded doctors with containing the costs.

Background The study aimed to estimate lidocaine (LID) pharmacokinetic parameter values in patients with impaired liver function, and to assess change in parameters related to the surgical intervention. Methods Patients with impaired liver function were subject to the test prior to, 3 and 7 days after the intervention. LID was administered in single i.v. dose of 1 mg/kg. Blood samples were collected at 15, 30 and 90 minutes after drug administration. Non-compartmental analysis was applied for calculating the pharmacokinetic parameters. Results The study included 17 patients with the diagnosis of cirrhosis and 41 patients with liver tumor. In both groups of patients, the values of the coefficients of correlation show the best correlation between CL and Child-Pugh score (-0.693, p<0.005) over other pharmacokinetic parameters. The results indicate worsening hepatic function on 3rd day after operation in comparison to the values of LID CL prior to operation (mean LID CL for patients with Child-Pugh class A are 25.91 L/h, 41.59 L/h, respectively; while for B class are 16.89 L/h, 22.65 L/h, respectively). On day 7th, the values of LID CL (mean value for patients with Child-Pugh class A and B are 40.98 L/h and 21.46 L/h, respectively) are increased in comparison to 3rd day after. Conclusions LID pharmacokinetic parameters consequently changed according to the severity of liver impairment, assessed by Child-Pugh score. Values of LID CL and Vd coupled with standard biochemical parameters may be used in obtaining the complete picture of hepatic status of patients.