Li Wei1, Xinyun Yang1, Jie Li1, Lianghui Liu1, Hongying Luo1, Zeguang Zheng1, Yi Wei1. 1. 1 Pharmacy Department of First Affiliated Hospital, 2 Guangzhou Institute of Respiratory Disease of First Affiliated Hospital, 3 Pharmacology Department of Pharmaceutical College, Guangzhou Medical University, Guangzhou 510182, China.
Abstract
BACKGROUND: Poor adherence leads to a high rate of exacerbation and poor health-related quality of life (HRQoL) in patients with chronic obstructive pulmonary disease (COPD). However, few strategies are acceptable and effective in improving medication adherence. We investigated whether pharmaceutical care by clinical pharmacists could reinforce medication adherence to reduce exacerbation and improve HRQoL. METHODS: A randomized controlled study was carried out at The First Affiliated Hospital of Guangzhou Medical University from February 2012 to January 2014. Non-adherence patients were randomly assigned to receive pharmaceutical care or to usual care. The pharmaceutical care consisted of individualized education and a series of telephone counseling for 6 months provided by clinical pharmacists. Medication adherence was measured by pill counts plus direct interview at 1- and 6-month pharmaceutical care and one-year follow-up. Severe exacerbations were defined as events that led to hospitalization for acute COPD attack. An interview was conducted to investigate hospital admissions and evaluate severe exacerbations at one-year follow-up. HRQoL was measured by St George's Respiratory Questionnaire at 6 months. RESULTS: At 6-month pharmaceutical care and one-year follow-up, the pharmaceutical care group exhibited higher medication adherence than the usual care group (73.4±11.1 vs. 55.7±11.9, P=0.016 and 54.4±12.5 vs. 66.5±8.6, P=0.039, respectively). There are 60 acute exacerbations resulted in a hospital admission in the usual group while 37 ones in the pharmaceutical care group during one-year follow-up (P=0.01). Hospital admissions due to acute exacerbation in the pharmaceutical care group were 56.3% less than the usual care group (P=0.01). There was a significant difference in the symptoms and impact subscales respectively at 6-month pharmaceutical care between two groups (P=0.032, P=0.018). CONCLUSIONS: Individualized pharmaceutical care improved medication adherence, reduced hospitalization and elevated HRQoL in patients with COPD.
RCT Entities:
BACKGROUND: Poor adherence leads to a high rate of exacerbation and poor health-related quality of life (HRQoL) in patients with chronic obstructive pulmonary disease (COPD). However, few strategies are acceptable and effective in improving medication adherence. We investigated whether pharmaceutical care by clinical pharmacists could reinforce medication adherence to reduce exacerbation and improve HRQoL. METHODS: A randomized controlled study was carried out at The First Affiliated Hospital of Guangzhou Medical University from February 2012 to January 2014. Non-adherence patients were randomly assigned to receive pharmaceutical care or to usual care. The pharmaceutical care consisted of individualized education and a series of telephone counseling for 6 months provided by clinical pharmacists. Medication adherence was measured by pill counts plus direct interview at 1- and 6-month pharmaceutical care and one-year follow-up. Severe exacerbations were defined as events that led to hospitalization for acute COPD attack. An interview was conducted to investigate hospital admissions and evaluate severe exacerbations at one-year follow-up. HRQoL was measured by St George's Respiratory Questionnaire at 6 months. RESULTS: At 6-month pharmaceutical care and one-year follow-up, the pharmaceutical care group exhibited higher medication adherence than the usual care group (73.4±11.1 vs. 55.7±11.9, P=0.016 and 54.4±12.5 vs. 66.5±8.6, P=0.039, respectively). There are 60 acute exacerbations resulted in a hospital admission in the usual group while 37 ones in the pharmaceutical care group during one-year follow-up (P=0.01). Hospital admissions due to acute exacerbation in the pharmaceutical care group were 56.3% less than the usual care group (P=0.01). There was a significant difference in the symptoms and impact subscales respectively at 6-month pharmaceutical care between two groups (P=0.032, P=0.018). CONCLUSIONS: Individualized pharmaceutical care improved medication adherence, reduced hospitalization and elevated HRQoL in patients with COPD.
Authors: J Vestbo; J A Anderson; P M A Calverley; B Celli; G T Ferguson; C Jenkins; K Knobil; L R Willits; J C Yates; P W Jones Journal: Thorax Date: 2009-08-23 Impact factor: 9.139
Authors: D K Solomon; T S Portner; G E Bass; D R Gourley; G A Gourley; J M Holt; W R Wicke; R L Braden; T N Eberle; T H Self; B L Lawrence Journal: J Am Pharm Assoc (Wash) Date: 1998 Sep-Oct
Authors: Anke Lenferink; Marjolein Brusse-Keizer; Paul Dlpm van der Valk; Peter A Frith; Marlies Zwerink; Evelyn M Monninkhof; Job van der Palen; Tanja W Effing Journal: Cochrane Database Syst Rev Date: 2017-08-04
Authors: Kirla B Detoni; Isabela V Oliveira; Mariana M G Nascimento; Thaís R Caux; Mateus R Alves; Djenane Ramalho-de-Oliveira Journal: Int J Clin Pharm Date: 2016-12-03
Authors: Jade Schrijver; Anke Lenferink; Marjolein Brusse-Keizer; Marlies Zwerink; Paul Dlpm van der Valk; Job van der Palen; Tanja W Effing Journal: Cochrane Database Syst Rev Date: 2022-01-10
Authors: Ana Juanes; Noe Garin; Maria Antonia Mangues; Sergio Herrera; Mireia Puig; Maria Jose Faus; Maria Isabel Baena Journal: Eur J Hosp Pharm Date: 2017-02-23
Authors: Mícheál de Barra; Claire L Scott; Neil W Scott; Marie Johnston; Marijn de Bruin; Nancy Nkansah; Christine M Bond; Catriona I Matheson; Pamela Rackow; A Jess Williams; Margaret C Watson Journal: Cochrane Database Syst Rev Date: 2018-09-04
Authors: Marise Oliveira-Santos; José Fernando de Souza Verani; Luiz Antônio Bastos Camacho; Carlos Augusto Ferreira de Andrade; Rosele Ferrante-Silva; Evandro Mendes Klumb Journal: Trials Date: 2016-04-02 Impact factor: 2.279