Effectiveness of Improving Medication Adherence and Lung Function for Patients With Chronic Obstructive Pulmonary Disease (COPD) in Pharmacists-Managed Outpatient Clinic (PMC): A Prospective Before-and-After Intervention Study.

RATIONALE

Improving the adherence of patients is importance for disease management and treatment outcomes.

OBECTIVES

To investigate the efficacy of medication therapy management services for patients with chronic diseases (PCD) including COPD in pharmacists-managed outpatient clinic (PMC).

METHODS

This study was a prospective before-and-after intervention study, which was conducted at Tongji University Affiliated East Hospital, a grade A tertiary hospital in Shanghai, China. PCD, including COPD, who visited the PMC from October 2019 to April 2023 were included in this study. Pharmacists administered interventions to patients with COPD during their initial visit, followed by a 3-month monitoring period. All patients received medication therapy management services and medication adherence assessments conducted by pharmacists. Drug-related problems (DRPs) were documented and the health-related quality of life (HRQoL) was evaluated using the European Five-dimensional questionnaire (EQ-5D). The medication adherence of patients with the top 10 chronic diseases was analyzed. The adherence and lung function of patients with COPD were assessed both before and after intervention.

RESULTS

A total of 713 patients were included in the study, with 768 DRPs identified. The mean EQ-5D utility and EQ visual analog scale (EQ-VAS) score were 0.91 ± 0.17 and 73.74 ± 14.3, respectively. Among the 425 patients, 8.5% exhibited high compliance, 69% medium compliance, and 22.5% poor compliance. Notably, patients with COPD demonstrated the highest proportion of medium adherence and the lowest proportion of high adherence. Following interventions for COPD patients, there was a notable increase in the proportion of medium adherence, and a significant improvement in overall adherece and FEV1 compared to pre-intervention levels (p < 0.05).

CONCLUSIONS

Pharmacists have the expertise to evaluate the DRPs, HRQoL and adherence of patients with PCD. Pharmacists performing medication therapy management services can enhance adherence and further improve the lung function of COPD patients.