Hu Yuqi, Yao Dongning, Ung Carolina Oi Lam, Hu Hao
State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macau, People's Republic of China.
Int J Chron Obstruct Pulmon Dis. 2020 Aug 3;15:1863-1875. doi: 10.2147/COPD.S254477. eCollection 2020.
This study aimed 1) to identify and analyse the professional services provided by community pharmacists for chronic obstructive pulmonary disease (COPD) management; and 2) to develop a logic model for community pharmacy practice for COPD management.
A systematic review with a logic model was applied. English-language databases (PubMed, Web of Science, Embase, and Scopus) and a Chinese database (CNKI) were searched for articles published between January 2009 and June 2019. Studies concerning pharmacists and COPD were identified to screen for studies that focused on professional services provided at a community pharmacy level. Evidence on economic, clinical, and humanistic outcomes of interventions was summarized.
Twenty-five articles were included in this study. Four categories of COPD-related interventions by community pharmacists were identified: 1) primary prevention; 2) early detection; 3) therapy management; and 4) long-term health management. The most common outputs examined were improvement in inhaler technique, medication adherence, and rate of smoking cessation. The clinical (improved quality of life, reduced frequency and severity of symptoms and exacerbation), humanistic (patient satisfaction), and economic (overall healthcare costs) outcomes were tested for some interventions through clinical studies. Contextual factors concerning pharmacists, healthcare providers, patients, facilities, clinic context, and socio-economic aspects were also identified.
Studies in the literature have proposed and examined different components of professional services provided by community pharmacists for COPD management. However, relationships among outcomes, comprehensive professional services of community pharmacists, and contextual factors have not been systematically tested. More well-designed, rigorous studies with more sensitive and specific outcomes measures need to be conducted to assess the effect of community pharmacy practice for COPD management.
本研究旨在1）识别并分析社区药剂师为慢性阻塞性肺疾病（COPD）管理提供的专业服务；2）构建社区药房COPD管理实践的逻辑模型。
采用系统综述并结合逻辑模型。检索了英文数据库（PubMed、Web of Science、Embase和Scopus）以及中文数据库（CNKI）中2009年1月至2019年6月发表的文章。筛选出关于药剂师与COPD的研究，以找出聚焦于社区药房层面提供的专业服务的研究。总结了干预措施在经济、临床和人文方面的成果证据。
本研究纳入了25篇文章。确定了社区药剂师开展的四类与COPD相关的干预措施：1）一级预防；2）早期检测；3）治疗管理；4）长期健康管理。所考察的最常见结果是吸入技术的改善、药物依从性和戒烟率。通过临床研究对一些干预措施的临床（生活质量改善、症状和急性加重的频率及严重程度降低）、人文（患者满意度）和经济（总体医疗费用）结果进行了测试。还确定了与药剂师、医疗服务提供者、患者、设施、诊所环境和社会经济方面相关的背景因素。
文献中的研究提出并考察了社区药剂师为COPD管理提供的专业服务的不同组成部分。然而，结果、社区药剂师的综合专业服务和背景因素之间的关系尚未得到系统测试。需要开展更多设计良好、严谨且具有更敏感和特异结果测量指标的研究，以评估社区药房实践对COPD管理的效果。
