Impact of pharmaceutical care on health outcomes in patients with COPD
Date
2011-11-20
Authors
Khdour, Maher
Jarab, Anan
AlQudah, Salam
Shamssain, Mohammed
Mukattash, Tareq
Journal Title
Journal ISSN
Volume Title
Publisher
Springer Science+Business Media B.V. 2011
Abstract
Background Chronic obstructive pulmonary disease
(COPD) treatment goals are often not achieved despite
the availability of many effective treatments. Furthermore,
clinical pharmacist interventions to improve clinical and
humanistic outcomes in COPD patients have not yet been
explored and few randomized controlled trials have been
reported to evaluate the impact of pharmaceutical care on
health outcomes in patients with COPD. Objective The aimof
the present studywas to evaluate the impact of pharmaceutical
care intervention,with a strong focus on self-management, on
a range of clinical and humanistic outcomes in patients with
COPD. Setting Outpatient COPD Clinic at the Royal Medical
Services Hospital. Method In a randomised, controlled, prospective
clinical trial, a total of 133 COPD patients were
randomly assigned to intervention or control group. A structured
education about COPD and management of its symptoms
was delivered by the clinical pharmacist for patients in
the intervention group. Patientswere followed up at 6 months
during a scheduled visit. Effectiveness of the intervention was
assessed in terms of improvement in health-related quality of
life,medication adherence, disease knowledge and healthcare
utilization. Data collected at baseline and at the 6 month
assessment was coded and entered into SPSS software version
17 for statistical analysis. A P value of\0.05 was considered
statistically significant. Main outcome measure The
primary outcome measure was health-related quality of life
improvement. All other data collected including healthcare
utilization, COPD knowledge and medication adherence
formed secondary outcome measures. Results A total of 66
patients were randomized to the intervention group and 67
patients were randomized to the control group. Although the
current study failed to illustrate significant improvement in
health-related quality of life parameters, the results indicated
significant improvements in COPD knowledge (P\0.001),
medication adherence (P\0.05), medication beliefs (P\
0.01) and significant reduction in hospital admission rates
(P\0.05) in intervention patients when compared with
control group patients at the end of the study. Conclusion The
enhanced patient outcomes as a result of the pharmaceutical
care programme in the present study demonstrate the value of
an enhanced clinical pharmacy service in achieving the
desired health outcomes for patients with COPD.
Description
Keywords
Adherence , Clinical pharmacist , COPD , Jordan , Pharmaceutical care , Quality of life