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Evaluating an integrated chronic obstructive pulmonary disease management program implemented in a primary care setting
Author(s) -
Kimball Brianna K.,
Tutalo Ronald A.,
Minami Taro,
Eaton Charles B.
Publication year - 2021
Publication title -
journal of the american college of clinical pharmacy
Language(s) - English
Resource type - Journals
ISSN - 2574-9870
DOI - 10.1002/jac5.1428
Subject(s) - medicine , copd , emergency department , referral , emergency medicine , physical therapy , family medicine , psychiatry
Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality. Objectives This study evaluated the impact of a COPD disease management program on patients' symptoms, exacerbations, and medication costs. Methods This was a single‐center, pre‐post intervention study. Patients with COPD were identified by ICD‐10‐CM diagnosis code with a hospitalization or emergency department (ED) visit for COPD or by physician referral. Eligible patients were enrolled in a COPD disease management program and received pharmacist services at an initial, in‐person visit then monthly telephonic visits over 3 months. Services included a medication review, COPD assessment test (CAT), (scores from 0 [low] to 40 [very high]) and education. Outcomes were compared pre‐ and post‐intervention using the Wilcoxon signed‐rank test. The primary outcome was the mean change in CAT score. Secondary outcomes were the difference in mean number of exacerbations, mean number of hospital admissions and ED visits, and mean total monthly maintenance inhaler regimen costs per patient. Results A total of 20 patients (mean age 61.8 years, 75% FEV1/FVC <0.7, 70% GOLD Group D) completed an initial visit and at least one follow‐up visit. The mean CAT score significantly improved by 8.73 points ( P < .01) The mean number of exacerbations standardized to a 1‐year time period significantly decreased by 1.35 ( P = .01) and the mean number of hospital admissions and emergency department visits significantly decreased by 0.85 ( P = .02). There was a significant cost savings of $248.29 for the mean monthly maintenance inhaler regimen costs per patient ( P < .01). Conclusion An integrated COPD program was associated with improved symptoms, reduced exacerbations, and decreased maintenance inhaler regimen costs.