Alton Sarah, Farndon Lisa
Head of Community Pharmacy, Combined Community and Acute Care Group; Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield.
Clinical Research Podiatrist/Research Lead, Integrated Community Care Directorate; Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield.
Br J Community Nurs. 2018 Jun 2;23(6):266-271. doi: 10.12968/bjcn.2018.23.6.266.
Chronic obstructive pulmonary disease (COPD) is a common long-term condition involving restricted airflow, which reduces quality of life. Treatments include lifestyle changes (smoking cessation), pulmonary rehabilitation and medication with inhaled therapies. However, medication adherence is often suboptimal, resulting in poor health outcomes. A pilot project assessed the impact of medicines management support from a community pharmacy team for people with COPD, delivered in their own homes. Individuals were given a medication review and an assessment of their inhaler technique and were followed up at 3 and 6 months. The COPD Assessment Test (CAT) score was administered before and after the intervention. A change in score of 2 or more suggests a significant difference; the average score was 19.2 at the first assessment and 16.7 at the six month follow-up. Seventeen patients had improved CAT scores, 10 patients had a reduced score and three remained unchanged. Most patients evaluated the project positively as it helped them to improve their inhaler technique. Medicines optimisation was also achieved as a person-centred approach was taken; suboptimal practice had not been picked up by health professionals previously. Community pharmacists working in integrated care teams provide invaluable support to patients with COPD. This project will be rolled out across the community team, and training on medicines management and inhaler technique provided to other health professionals involved in the care of these patients.
慢性阻塞性肺疾病（COPD）是一种常见的长期病症，涉及气流受限，会降低生活质量。治疗方法包括生活方式改变（戒烟）、肺康复以及吸入疗法用药。然而，药物依从性往往不尽人意，导致健康状况不佳。一个试点项目评估了社区药房团队为COPD患者提供的居家药物管理支持的影响。为患者进行了药物审查和吸入器使用技术评估，并在3个月和6个月时进行随访。在干预前后进行了慢性阻塞性肺疾病评估测试（CAT）评分。评分变化2分或更多表明有显著差异；首次评估时的平均评分为19.2分，六个月随访时为16.7分。17名患者的CAT评分有所提高，10名患者评分降低，3名患者保持不变。大多数患者对该项目给予了积极评价，因为它帮助他们提高了吸入器使用技术。由于采用了以患者为中心的方法，还实现了药物优化；此前卫生专业人员并未发现存在的欠佳做法。在综合护理团队中工作的社区药剂师为COPD患者提供了宝贵的支持。该项目将在整个社区团队中推广，并为参与这些患者护理的其他卫生专业人员提供药物管理和吸入器技术培训。
