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- Title
Effectiveness of pharmaceutical care for patients with chronic obstructive pulmonary disease ( PHARMACOP): a randomized controlled trial.
- Authors
Tommelein, Eline; Mehuys, Els; Van Hees, Thierry; Adriaens, Els; Van Bortel, Luc; Christiaens, Thierry; Van Tongelen, Inge; Remon, Jean‐Paul; Boussery, Koen; Brusselle, Guy
- Abstract
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.
- Subjects
ELDER care; DYSPNEA; RANDOMIZED controlled trials; HOSPITAL care; PULMONARY manifestations of general diseases
- Publication
British Journal of Clinical Pharmacology, 2014, Vol 77, Issue 5, p756
- ISSN
0306-5251
- Publication type
Article
- DOI
10.1111/bcp.12242