COPD; adherence; exacerbation; inhalation therapy; pharmaceutical care
Abstract :
[en] AIM: Few well-designed randomized controlled trials (RCT) regarding the impact of community pharmacist interventions on pharmacotherapeutic monitoring of patients with Chronic Obstructive Pulmonary Disease (COPD) have been conducted. We assessed the effectiveness of a pharmaceutical care program for patients with COPD. METHODS: The PHARMACOP-trial is a single-blind 3-month RCT, conducted in 170 community pharmacies in Belgium, enrolling patients prescribed daily COPD medication, aged >/=50 years, and with a smoking history >/=10 pack-years. A computer-generated randomization sequence allocated patients to intervention (n=371), receiving protocol-defined pharmacist care, or control group (n=363), receiving usual pharmacist care (1:1 ratio, stratified by center). Interventions, focusing on inhalation technique and adherence to maintenance therapy, were carried out at start of the trial and at one month follow-up. Primary outcomes were inhalation technique and medication adherence. Secondary outcomes were exacerbation rate, dyspnea, COPD specific and generic health status and smoking behavior. RESULTS: From December 2010 to April 2011, 734 patients were enrolled. 42 patients (5.7%) were lost to follow-up. At the end of the trial, inhalation score (Mean estimated difference [Delta],13.5%; 95% Confidence Interval [CI], 10.8-16.1; P<.0001) and medication adherence (Delta, 8.51%; 95%CI, 4.63-12.4; P<.0001) were significantly higher in the intervention group compared to the control group. In the intervention group, a significantly lower hospitalization rate was observed (9 vs 35; Rate Ratio, 0.28; 95%CI, 0.12-0.64; P=.003). No other significant between-group differences were observed. CONCLUSION: Pragmatic pharmacist care programs improve the pharmacotherapeutic regime in patients with COPD and could reduce hospitalization rates.
Disciplines :
Pharmacy, pharmacology & toxicology
Author, co-author :
Tommelein, Eline
Mehuys, Els
Van Hees, Thierry ; Université de Liège - ULiège > Département de pharmacie > Pharmacie clinique et pharmacie hospitalière
Adriaens, Els
Van Bortel, Luc
Christiaens, Thierry
Van Tongelen, Inge
Remon, Jean-Paul
Boussery, Koen
Brusselle, Guy
Language :
English
Title :
Effectiveness of PHARMAceutical care for patients with COPD (PHARMACOP): a randomized controlled trial
Publication date :
2014
Journal title :
British Journal of Clinical Pharmacology
ISSN :
0306-5251
eISSN :
1365-2125
Publisher :
Blackwell, Oxford, United Kingdom
Volume :
77
Issue :
5
Pages :
756-766
Peer reviewed :
Peer Reviewed verified by ORBi
Commentary :
This article is protected by copyright. All rights reserved.
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