The impact of pharmacist-managed clinic on medication adherence and health-related quality of life in patients with COPD: a randomized controlled study

Abstract

IntroductionCOPD is rapidly becoming one of the most challenging health problems worldwide, which is characterized by not fully reversible airflow limitation. Although a lot of treatment medications have been delivered, the treatment goals of COPD are often not achieved. Furthermore, few well-designed randomized controlled trials in the People’s Republic of China have been reported to evaluate the impact of pharmacist-managed clinic (PMC) on medication adherence and health-related quality of life in patients with COPD.MethodsA prospective randomized controlled study (on a PMC group and a control group) was conducted between January 2015 and December 2015. A structured education about COPD was provided by a clinical pharmacist to the PMC group. Primary outcomes were medication adherence (assessed by medication refill adherence scores) and health-related quality of life (assessed by St George’s Respiratory Questionnaire). Secondary outcomes were exacerbation rate, hospitalization rate, and smoking behavior.ResultsA total of 244 patients were enrolled for our study. The PMC group showed a significantly greater improvement in medication adherence compared with the baseline (93.1±14.2 vs 78.8±12.3, P<0.01). When compared with the control group, there were more patients whose medication refill adherence score was ≥80 in the PMC group (83.3% vs 51.3%, P<0.01). The total St George’s Respiratory Questionnaire scores was found to be improved significantly in the PMC group (42.7±3.2 vs 52.4±5.2, P<0.05). There was a lower hospitalization rate in the PMC group, and more patients in the PMC group quit smoking (71.0% vs 52.2%, P<0.05).ConclusionThe PMC may result in improvement of medication adherence and the health-related quality of life in patients with COPD. In the PMC group, a significant reduction in exacerbation rate, hospitalization rate, and smoking behavior was observed; therefore, our study provides support for a greater involvement of PMC in the care of patients with COPD.

Impact of home medication management review on medication adherence among Jordanian patients

“…A prospective randomised controlled trial assessed the impact of pharmacist-managed clinic (similar to the HMMR service) on medication adherence in COPD patients. [27] The Table 3 Changes in the medication nonadherence frequencies as a result of intervention n (%) in both study groups study showed a significantly greater improvement in medication adherence compared with baseline and to the control group, which was still found after 12 months, attributed to the service received from the clinical pharmacist. [27] Many strategies are found to improve patient's adherence.…”

“…[27] The Table 3 Changes in the medication nonadherence frequencies as a result of intervention n (%) in both study groups study showed a significantly greater improvement in medication adherence compared with baseline and to the control group, which was still found after 12 months, attributed to the service received from the clinical pharmacist. [27] Many strategies are found to improve patient's adherence. Providing patient home visits is an important strategy required by some patients for adherence to be optimised.…”

“…showed that 24% of the patients became highly adherent and 68% reached medium adherence reflecting on the positive role of the pharmacist and the value of the MMR service. A prospective randomised controlled trial assessed the impact of pharmacist‐managed clinic (similar to the HMMR service) on medication adherence in COPD patients . The study showed a significantly greater improvement in medication adherence compared with baseline and to the control group, which was still found after 12 months, attributed to the service received from the clinical pharmacist …”

Effect of pharmacist‐led interventions on medication adherence and inhalation technique in adult patients with asthma or COPD: A systematic review and meta‐analysis

“…The reasons for exclusion were as follows: not asthma or COPD patients, not a RCT, not pharmacist-led, no usual care control group, no outcome of interest and others. We included 13 studies 29-41 , 10 studies [29][30][31][33][34][35][36][37]40,41 reported medication adherence, 3 studies 30,33,34 could not be included in quantitative analysis because of the lack of available original data; 7 studies [31][32][33][34][38][39][40] reported inhalation technique, 3 studies 33,38,39 could not be included in quantitative analysis because of the lack of dichotomous data. The process of article selection is presented in Figure 1.…”

Clinical Pharmacists in Chronic Care

“…It is the second most common reason for emergency hospital admission.According to WHO, COPD has become the fourth leading cause of mortality in the US. It is estimated to become the fifth leading cause of disease burden in 2020 [128]. In 2015 alone, the death toll due to asthma was 383,000 globally [129].…”