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Randomized Controlled Trial
. 2009 Oct;68(4):588-98.
doi: 10.1111/j.1365-2125.2009.03493.x.

Clinical pharmacy-led disease and medicine management programme for patients with COPD

Maher R Khdour  1 , Joseph C Kidney, Bronagh M Smyth, James C McElnay
Affiliations
Randomized Controlled Trial

Clinical pharmacy-led disease and medicine management programme for patients with COPD

Maher R Khdour et al. Br J Clin Pharmacol. 2009 Oct.

Abstract

Aim: The aim was to investigate the impact of a disease and medicine management programme, focusing on self-management in patients with chronic obstructive pulmonary disease (COPD).

Methods: One hundred and seventy-three patients (mean age 67 years; 54% female) were recruited; 86 patients were randomly assigned to an intervention group and 87 to a usual care (control) group. Intervention patients received education on disease state, medications and breathing techniques. Patients were given booklets and a customized action plan (antibiotic and oral steroid to be initiated promptly by patients for exacerbations). Patients were followed up at 6 and 12 months during a scheduled visit. The St George's Respiratory Questionnaire (SGRQ), COPD Knowledge and Morisky adherence questionnaires were administered to all patients at baseline, 6 and 12 months. Outcome measures included hospital admissions, emergency department (ED) visits, health-related quality of life (HRQoL) and medication adherence.

Results: Over the 12-month period in the intervention group, ED visits decreased by 50% (P= 0.02) and hospitalization by approximately 60% (P= 0.01). On the SGRQ, differences reached statistical significance on the symptom (-7.5; P= 0.04) and impact (-7.4; P= 0.03) subscales but not on the physical activity subscale. There was a significant difference between the intervention and usual care groups regarding knowledge scores (75.0 vs. 59.3; P= 0.001) and good adherence to medication (77.8% vs. 60.0%, P= 0.019). There was no significant difference regarding smoking between study groups.

Conclusions: The clinical pharmacy-led management programme can improve adherence, reduce the need for hospital care in patients with COPD and improve aspects of their HRQoL.

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Figures

Figure 1
Figure 1
Flow chart indicating patient numbers at different stages of the study
Figure 2
Figure 2
Percentage of patients who reported high adherence in intervention and control group at each assessment point. (*P= 0.019). Intervention (formula image); Control (formula image)
See this image and copyright information in PMC

References

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