Structured pharmacist-led intervention programme to improve medication adherence in COPD patients: A randomized controlled study

被引:64
作者
Abdulsalim, Suhaj [1 ,2 ]
Unnikrishnan, Mazhuvancherry Kesavan [1 ,3 ]
Manu, Mohan K. [4 ]
Alrasheedy, Alian A. [2 ]
Godman, Brian [5 ,6 ]
Morisky, Donald E. [7 ,8 ]
机构
[1] Manipal Univ, Manipal Coll Pharmaceut Sci, Dept Pharm Practice, Manipal 576104, Karnataka, India
[2] Qassim Univ, Unaizah Coll Pharm, Dept Pharm Practice, Buraydah, Saudi Arabia
[3] Natl Coll Pharm, Dept Pharmacol, Kozhikode, Kerala, India
[4] Manipal Univ, Kasturba Med Coll Hosp, Dept Pulm Med, Manipal 576104, Karnataka, India
[5] Karolinska Inst, Div Clin Pharmacol, Stockholm, Sweden
[6] Strathclyde Univ, Strathclyde Inst Pharm & Biomed Sci, Glasgow, Lanark, Scotland
[7] Kaohsiung Univ, Kaohsiung, Taiwan
[8] Univ Calif Los Angeles, Dept Community Hlth Sci, Fielding Sch Publ Hlth, 650 Charles E Young Dr South, Los Angeles, CA USA
关键词
Pharmacist intervention; Medication adherence; COPD patients; Randomized controlled study; MAQ; OBSTRUCTIVE PULMONARY-DISEASE; SMOKING-CESSATION INTERVENTION; QUALITY-OF-LIFE; PHARMACEUTICAL CARE; INHALER; IMPACT; NONADHERENCE; KNOWLEDGE;
D O I
10.1016/j.sapharm.2017.10.008
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Background: COPD is characterised by a progressive airflow limitation in the lungs. However, adherence to therapy improves management of symptoms and delays disease progression. Therefore, patients' knowledge and awareness about the disease are important. Hence, pharmacist-led educational interventions could achieve this and improve medication adherence. Objective: This study evaluated the effectiveness of a clinical pharmacist-led intervention on medication adherence in COPD patients in a teaching hospital. Methods: In an open-labelled randomized controlled study at Kasturba Medical College Hospital, Manipal, India, patients were randomly assigned to two groups (Intervention group [IG] and Control group [CG]), and were matched for socio-demographics and clinical characteristics. Medication adherence was assessed by the Morisky, Green and Levine Medication Adherence Questionnaire (MAQ). In IG, pharmacist intervention placed emphasis on (1) compliance, (2) smoking cessation, (3) exercise, (4) inhaler use and (5) need for timely follow up. The MAQ assessment was repeated at 6, 12, 18 and 24 months. Data were analysed statistically by SPSS version 20.0. Results: Out of 328 patients screened during March 2012 to June 2013, 260 were recruited. Of these, 206 completed the follow-up (98 in CG and 104 in IG). Medication adherence improved significantly after pharmacist intervention in IG at all follow-up time points (P < 0.001). It increased from 49% at the baseline to 80% after 24 months (P < 0.001). Carelessness about taking medicines was one of the main reasons for non-adherence in COPD patients, but was effectively reduced by the intervention. Conclusions: This is the first randomized controlled trial in India that demonstrates the pivotal role of pharmacist-led educational intervention in improving medication adherence in COPD. Involving non-physician health professionals could be the best strategy, for resource-poor nations like India, because the current physician-centric healthcare has no emphasis on patient education and counselling.
引用
收藏
页码:909 / 914
页数:6
相关论文
共 50 条
[1]   Global and regional estimates of COPD prevalence: Systematic review and meta-analysis [J].
Adeloye, Davies ;
Chua, Stephen ;
Lee, Chinwei ;
Basquill, Catriona ;
Papana, Angeliki ;
Theodoratou, Evropi ;
Nair, Harish ;
Gasevic, Danijela ;
Sridhar, Devi ;
Campbell, Harry ;
Chan, Kit Yee ;
Sheikh, Aziz ;
Rudan, Igor .
JOURNAL OF GLOBAL HEALTH, 2015, 5 (02) :186-202
[2]   Correlation of severity of chronic obstructive pulmonary disease with health-related quality of life and six-minute walk test in a rural hospital of central India [J].
Agrawal, Sachin R. ;
Joshi, Rajnish ;
Jain, Ajitprasad .
LUNG INDIA, 2015, 32 (03) :233-240
[3]   The impact of smoking-cessation intervention by multiple health professionals [J].
An, Lawrence C. ;
Foldes, Steven S. ;
Alesci, Nina L. ;
Bluhm, James H. ;
Bland, Patricia C. ;
Davern, Michael E. ;
Schillo, Barbara A. ;
Ahluwalia, Jasjit S. ;
Manley, Marc W. .
AMERICAN JOURNAL OF PREVENTIVE MEDICINE, 2008, 34 (01) :54-60
[4]  
[Anonymous], 2015, WORLD MED SITUATION
[5]  
[Anonymous], INT J RES DEV HEAL
[6]  
[Anonymous], 2015, ASIAN J PHARM HEA SC, DOI DOI 10.3389/FPSYT.2019.00442
[7]   Inhaled corticosteroid use and associated outcomes in elderly patients with moderate to severe chronic pulmonary disease [J].
Balkrishnan, R ;
Christensen, DB .
CLINICAL THERAPEUTICS, 2000, 22 (04) :452-469
[8]   Inhaler device selection: Special considerations in elderly patients with chronic obstructive pulmonary disease [J].
Barrons, Robert ;
Pegram, Angela ;
Borries, Alaina .
AMERICAN JOURNAL OF HEALTH-SYSTEM PHARMACY, 2011, 68 (13) :1221-1232
[9]  
Bosley C, 1996, EUR RESP J, P9
[10]   The use of multiple respiratory inhalers requiring different inhalation techniques has an adverse effect on COPD outcomes [J].
Bosnic-Anticevich, Sinthia ;
Chrystyn, Henry ;
Costello, Richard W. ;
Dolovich, Myrna B. ;
Fletcher, Monica J. ;
Lavorini, Federico ;
Rodriguez-Roisin, Roberto ;
Ryan, Dermot ;
Ming, Simon Wan Yau ;
Price, David B. .
INTERNATIONAL JOURNAL OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE, 2017, 12 :59-71