Article date: May 2014
By: Eline Tommelein, Els Mehuys, Thierry Van Hees, Els Adriaens, Luc Van Bortel, Thierry Christiaens, Inge Van Tongelen, Jean‐Paul Remon, Koen Boussery, Guy Brusselle, in Volume 77, Issue 5, pages 756-766
Aims
Few well‐designed randomized controlled trials have been conducted regarding the impact of community pharmacist interventions on pharmacotherapeutic monitoring of patients with chronic obstructive pulmonary disease (COPD). We assessed the effectiveness of a pharmaceutical care programme for patients with COPD.
Methods
The pharmaceutical care for patients with COPD (PHARMACOP) trial is a single‐blind 3 month randomized controlled trial, conducted in 170 community pharmacies in Belgium, enrolling patients prescribed daily COPD medication, aged ≥50 years and with a smoking history of ≥10 pack‐years. A computer‐generated randomization sequence allocated patients to an intervention group (n = 371), receiving protocol‐defined pharmacist care, or a control group (n = 363), receiving usual pharmacist care (1:1 ratio, stratified by centre). Interventions focusing on inhalation technique and adherence to maintenance therapy were carried out at start of the trial and at 1 month follow‐up. Primary outcomes were inhalation technique and medication adherence. Secondary outcomes were exacerbation rate, dyspnoea, COPD‐specific and generic health status and smoking behaviour.
Results
From December 2010 to April 2011, 734 patients were enrolled. Forty‐two patients (5.7%) were lost to follow‐up. At the end of the trial, inhalation score [mean estimated difference (Δ),13.5%; 95% confidence interval (CI), 10.8–16.1; P < 0.0001] and medication adherence (Δ, 8.51%; 95% CI, 4.63–12.4; P < 0.0001) were significantly higher in the intervention group compared with 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 = 0.003). No other significant between‐group differences were observed.
Conclusions
Pragmatic pharmacist care programmes improve the pharmacotherapeutic regimen in patients with COPD and could reduce hospitalization rates.
DOI: 10.1111/bcp.12242
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