Effectiveness of pharmaceutical care for patients with chronic obstructive pulmonary disease ( PHARMACOP): a randomized controlled trial

E Tommelein, E Mehuys, T Van Hees, E Adriaens, L Van Bortel, T Christiaens, I Van Tongelen, JP Remon, K Boussery, Guy Brusselle

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Abstract

AimsFew 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. MethodsThe pharmaceutical care for patients with COPD (PHARMACOP) trial is a single-blind 3month randomized controlled trial, conducted in 170 community pharmacies in Belgium, enrolling patients prescribed daily COPD medication, aged 50years 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 1month 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. ResultsFrom 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 (),13.5%; 95% confidence interval (CI), 10.8-16.1; P < 0.0001] and medication adherence (, 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. ConclusionsPragmatic pharmacist care programmes improve the pharmacotherapeutic regimen in patients with COPD and could reduce hospitalization rates.
Original languageUndefined/Unknown
Pages (from-to)756-766
Number of pages11
JournalBritish Journal of Clinical Pharmacology
Volume77
Issue number5
DOIs
Publication statusPublished - 2014

Research programs

  • EMC MM-04-42-02

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