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Effectiveness of pharmaceutical care for patients with chronic obstructive pulmonary disease ( PHARMACOP ): a randomized controlled trial
Author(s) -
Tommelein Eline,
Mehuys Els,
Van Hees Thierry,
Adriaens Els,
Van Bortel Luc,
Christiaens Thierry,
Van Tongelen Inge,
Remon JeanPaul,
Boussery Koen,
Brusselle Guy
Publication year - 2014
Publication title -
british journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.216
H-Index - 146
eISSN - 1365-2125
pISSN - 0306-5251
DOI - 10.1111/bcp.12242
Subject(s) - medicine , randomized controlled trial , copd , pharmacist , randomization , exacerbation , confidence interval , pharmacy , pharmaceutical care , psychological intervention , rate ratio , physical therapy , emergency medicine , family medicine , nursing
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 B elgium, 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 D ecember 2010 to A pril 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.