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Evaluation of pharmacist care for patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis

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Abstract

Background In chronic obstructive pulmonary disease (COPD), the value of pharmacist care is not clear. Aim of the review A systematic review was conducted to clarify the impact of pharmacist care for outpatients with COPD. Methods The PubMed, EMBASE, CINAHL, CBMdisc, and Cochrane Central Register of Controlled Trials databases were searched for randomized controlled trials that involved pharmacist-care interventions among outpatients with COPD. The reference lists were also screened for any additional relevant studies not identified through the electronic database searching. Two reviewers independently assessed each paper for methodological quality and extracted the data. Results Fourteen articles were included. These articles described eight randomized controlled trials (1,327 patients) that pharmacist care was compared with usual care. The pharmacist interventions included those exclusively conducted by pharmacists and those conducted in collaboration with a multidisciplinary team. Although the current evidences failed to illustrate significant improvement in the health-related quality of life in intervention patients, results indicated that pharmacist care was associated with a significant reduction in the risk of hospital admissions [six studies (684 patients); risk ratio 0.50 (95 % CI 0.39–0.64)]. However, no significant effect was found either in emergency department visits or in lung function. In addition, pharmacist care improved medication compliance of patients [four studies (743 patients); risk ratio 1.23 (95 % CI 1.11–1.36)] while reduced health-related cost [three studies (318 patients); standardized mean difference −0.37 (95 % CI −0.59 to −0.15)]. Conclusion Pharmacist care resulted in improvements in the medication compliance as well as reductions in hospital admissions and health-related costs. It is therefore a potent strategy for management of outpatients with COPD.

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References

  1. GOLD. Global Initiative for Chronic Obstructive Lung Disease. Available from: http://www.goldcopd.org/. Updated 2013.

  2. Rabe KF, Hurd S, Anzueto A, Barnes PJ, Buist SA, Calverley P, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med. 2007;176(6):532–55.

    Article  PubMed  Google Scholar 

  3. Chong J, Karner C, Poole P. Tiotropium versus long-anting beta-agonists for stable chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2012;9:CD009157.

    PubMed  Google Scholar 

  4. Weinberger M, Murray MD, Marrero DG, Brewer N, Lykens M, Harris LE, et al. Effectiveness of pharmacist care for patients with reactive airways disease: a randomized controlled trial. JAMA. 2002;288(13):1594–602.

    Article  PubMed  Google Scholar 

  5. Nkansah N, Mostovetsky O, Yu C, Chheng T, Beney J, Bond CM, et al. Effect of outpatient pharmacists’ non-dispensing roles on patient outcomes and prescribing patterns. Cochrane Database Syst Rev. 2010;7:CD000336.

    PubMed  Google Scholar 

  6. Arya V, Pinto S, Singer J, Khan T. Understanding awareness of pharmacist-led medication therapy management among primary care physicians in New York City using qualitative methods: part I. J Med Pract Manag. 2013;29(2):84–8.

    Google Scholar 

  7. Santschi V, Chiolero A, Burnand B, Colosimo AL, Paradis G. Impact of pharmacist care in the management of cardiovascular disease risk factors: a systematic review and meta-analysis of randomized trials. Arch Intern Med. 2011;171(16):1441–53.

    Article  CAS  PubMed  Google Scholar 

  8. Carter BL, Rogers M, Daly J, Zheng S, James PA. The potency of team-based care interventions for hypertension: a meta-analysis. Arch Intern Med. 2009;169(19):1748–55.

    Article  PubMed Central  PubMed  Google Scholar 

  9. Collins C, Limone BL, Scholle JM, Coleman CI. Effect of pharmacist intervention on glycemic control in diabetes. Diabetes Res Clin Pract. 2011;92(2):145–52.

    Article  PubMed  Google Scholar 

  10. Armor BL, Britton ML, Dennis VC, Letassy NA. A review of pharmacist contributions to diabetes care in the United States. J Pharm Pract. 2010;23(3):250–64.

    Article  PubMed  Google Scholar 

  11. Benavides S, Rodriguez JC, Maniscalco-Feichtl M. Pharmacist involvement in improving asthma outcomes in various healthcare settings: 1997 to present. Ann Pharmacother. 2009;43(1):85–97.

    Article  PubMed  Google Scholar 

  12. Khdour MR, Kidney JC, Smyth BM, McElnay JC. Clinical pharmacy-led disease and medicine management programme for patients with COPD. Br J Clin Pharmacol. 2009;68(4):588–98.

    Article  PubMed Central  PubMed  Google Scholar 

  13. Gorgas TMQ, Pàez VF, Camós RJ, Jolonch SP, Homs PE, Schoenenberger AJA, et al. [Integrated pharmaceutical care programme in patients with chronic diseases]. Farm Hosp (1130-6343). 2012;36(4):229–39.

    Article  Google Scholar 

  14. Jarab AS, Alqudah SG, Khdour M, Shamssain M, Mukattash TL. Impact of pharmaceutical care on health outcomes in patients with COPD. Int J Clin Pharm. 2012;34(1):53–62.

    Article  PubMed  Google Scholar 

  15. Cochrane Airways Group. Search methods for the Cochrane Airways Group Specialised Register. http://airways.cochrane.org/sites/airways.cochrane.org/files/uploads/Search%20strategies%20document_2013.pdf.

  16. Effective Practice and Organisation of Care (EPOC). Pre-2008 EPOC Search Methods. http://epoc.cochrane.org/pre-2008-epoc-search-methods.

  17. Higgins JP, Altman DG, Gotzsche PC, Juni P, Moher D, Oxman AD, et al. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ (Clin Res ed). 2011;343:d5928.

    Article  Google Scholar 

  18. Higgins JP, Green S. Cochrane Handbook for Systematic Reviews of Interventions: Cochrane Book Series: Wiley, Chichester, UK; 2008.

  19. Review Manager (RevMan) [Computer program]. Version 5.2. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration; 2012.

  20. Gourley GA, Portner TS, Gourley DR, Rigolosi EL, Holt JM, Solomon DK, et al. Humanistic outcomes in the hypertension and COPD arms of a multicenter outcomes study. J Am Pharm Assoc (Wash). 1998;38(5):586–97.

    CAS  Google Scholar 

  21. Solomon DK, Portner TS, Bass GE, Gourley DR, Gourley GA, Holt JM, et al. Clinical and economic outcomes in the hypertension and COPD arms of a multicenter outcomes study. J Am Pharm Assoc (Wash). 1998;38(5):574–85.

    CAS  Google Scholar 

  22. Li Z, Fang Z, Ge M, Yang R, Zhu Y. Effects of integrated pharmaceutical care on patients with chronic obstructive pulmonary disease in community. Chin J Gen Pract. 2010;8(12):1561–3.

    CAS  Google Scholar 

  23. Wei L, Li J, Luo H, Wei Y, Yang X, Liu L. Effects of pharmacy service on disease analysis and quality of life of chronic obstructive pulmonary disease. China Med Herald. 2013;10(17):163–5.

    CAS  Google Scholar 

  24. Gallefoss F, Bakke PS, Rsgaard PK. Quality of life assessment after patient education in a randomized controlled study on asthma and chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 1999;159:812–7.

    Article  CAS  PubMed  Google Scholar 

  25. Gallefoss F. The effects of patient education in COPD in a 1-year follow-up randomised, controlled trial. Patient Educ Couns. 2004;52(3):259–66.

    Article  PubMed  Google Scholar 

  26. Khdour MR, Agus AM, Kidney JC, Smyth BM, Elnay JC, Crealey GE. Cost-utility analysis of a pharmacy-led self-management programme for patients with COPD. Int J Clin Pharm. 2011;33(4):665–73.

    Article  PubMed  Google Scholar 

  27. Wei L, Li J, Luo H, Wei Y, Yang X, Liu L. Effects of pharmaceutical care on drug compliance of patients with chronic obstructive pulmonary disease in stable phase. China Pharm. 2013;24(14):1316–8.

    Google Scholar 

  28. Fang Z, Li Z, Ge M, Yang R, Zhu Y. Cost-effectiveness of integrated pharmaceutical care in community-based patients with chronic obstructive pulmonary disease. Shanghai Med. 2012;11(7):507–10.

    Google Scholar 

  29. Li Z, Fang Z, Ge M, Yang R, Zhu Y. Intervention effects of integrated pharmaceutical care for community chronic obstructive pulmonary disease patients. Chin Genl Pract. 2011;14(13):1496–500.

    Google Scholar 

  30. Jan Brozek AO, Holger Schünemann. GRADEpro. [Computer program]. Version 3.2 for Windows 2008.

  31. Jones P. Quality of life measurement for patients with diseases of the airways. Thorax. 1991;46:676–82.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  32. Jones PW, Quirk FH, Baveystock CM, Littlejohns P. A self-complete measure of health status for chronic airflow limitation. The St. George’s Respiratory Questionnaire. Am Rev Respir Dis. 1992;145(6):1321–7.

    Article  CAS  PubMed  Google Scholar 

  33. Jones PW. Interpreting thresholds for a clinically significant change in health status in asthma and COPD. Eur Respir J. 2002;19(3):398–404.

    Article  CAS  PubMed  Google Scholar 

  34. Fang Z, Cai Y, Wang L, Liang Y, Chen J, Deng X. A measure of quality of life for patients with Chronic obstructive pulmonary disease. Mod Rehabil. 2012;5(4):7–8.

    Google Scholar 

  35. Guyatt GH, Berman LB, Townsend M, Pugsley SO, Chambers LW. A measure of quality of life for clinical trials in chronic lung disease. Thorax. 1987;42(10):773–8.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  36. Radosevich D, Wetzler H, Wilson S, Wetzler H, Wilson S. Health status questionnaire (HSQ) 2.0: scoring comparisons and reference data. Bloomington, Minn: Health outcomes institute; 1994.

    Google Scholar 

  37. Morisky D, Green L, Levine D. Concurrent and predictive validity of a self-reported measure of medication adherence. Med Care. 1986;24:67–74.

    Article  CAS  PubMed  Google Scholar 

  38. La Monica EL, Oberst MT, Madea AR, Wolf RM. Development of a patient satisfaction scale. Res Nurs Health. 1986;9(1):43–50.

    Article  PubMed  Google Scholar 

  39. Munro B, Jacobsen B, Brooten D. Re-examination of the psychometric characteristics of the La Monica-Oberst Patient Satisfaction Scale. Res Nurs Health. 1994;17:119–25.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  40. Ware JE, Jr., Davies-Avery A, Stewart AL. The measurement and meaning of patient satisfaction. Health Med Care Serv Rev. 1978;1(1):1, 3–15.

  41. Ware JE Jr, Snyder MK, Wright WR, Davies AR. Defining and measuring patient satisfaction with medical care. Eval Program Plan. 1983;6(3–4):247–63.

    Article  Google Scholar 

  42. Research Applied, Limited Communications. The Life Quality of Asthma. London: Allen & Hanburys; 1991.

    Google Scholar 

  43. British National Formulary. 51. British Medical Association and the Royal Pharmaceutical Society of Great Britain. London; 2006.

  44. Pande S, Hiller JE, Nkansah N, Bero L. The effect of pharmacist-provided non-dispensing services on patient outcomes, health service utilisation and costs in low-and middle-income countries. Cochrane Database Syst Rev. 2013;2:CD010398.

    PubMed  Google Scholar 

  45. Bourbeau J, Julien M, Maltais F, Rouleau M, Beaupre A, Begin R, et al. Reduction of hospital utilization in patients with chronic obstructive pulmonary disease: a disease-specific self-management intervention. Arch Intern Med. 2003;163(5):585–91.

    Article  PubMed  Google Scholar 

  46. Turnock AC, Walters EH, Walters JA, Wood-Baker R. Action plans for chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2005;4:CD005074.

    PubMed  Google Scholar 

  47. Bourbeau J, Collet JP, Schwartzman K, Ducruet T, Nault D, Bradley C. Economic benefits of self-management education in COPD. Chest. 2006;130(6):1704–11.

    Article  PubMed  Google Scholar 

  48. Fletcher C, Peto R. The natural history of chronic airflow obstruction. BMJ. 1977;1(6077):1645–8.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  49. NICE. National Institute for Health and Clinical Excellence: Guide to the methods of technology appraisal. London: NICE; 2008. [cited 2011 8 Feb]. Available from: http://www.nice.org.uk/media/B52/A7/TAMethodsGuideUpdatedJune2008.pdf.

  50. McLean S, Nurmatov U, Liu J, Pagliari C, Car J, Sheikh A. Telehealthcare for chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2011;7:CD007718.

    PubMed  Google Scholar 

  51. Monninkhof E, van der Valk P, van der Palen J, van Herwaarden C, Partridge M, Zielhuis G. Self-management education for patients with chronic obstructive pulmonary disease. Thorax. 2003;58:394–8.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  52. Effing T, Monninkhof E, van der Valk P, Zielhuis G, Walters E, van der Palen J, et al. Self-management education for patients with chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2007;47:CD002990.

    Google Scholar 

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Acknowledgments

We thank Phil Wiffen and Jun Xia of the “Cochrane Schizophrenia Group” for their supports and advices. We are also grateful to Hui Liu at the library of Shanghai Jiao Tong University for purchasing the full-text of the studies. In addition, we appreciate all the authors of the original articles.

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  1. Department of Pharmacy, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, 160 Pujian Road, Shanghai, 200127, China

    Han Zhong, Xiao-Jun Ni, Min Cui & Xiao-Yan Liu

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Correspondence to Xiao-Yan Liu.

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Zhong, H., Ni, XJ., Cui, M. et al. Evaluation of pharmacist care for patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis. Int J Clin Pharm 36, 1230–1240 (2014). https://doi.org/10.1007/s11096-014-0024-9

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