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

IF 2.1 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES

Journal of evaluation in clinical practice Pub Date : 2025-07-28 DOI:10.1111/jep.70218

Fang Fang, Xiaobo Zhai, Xiucong Fan, Ron Bai, Siwei Bao, Yabin Ma, Xiaohui Dong

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引用次数: 0

Abstract

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.

查看原文本刊更多论文

在药剂师管理的门诊（PMC）改善慢性阻塞性肺疾病（COPD）患者服药依从性和肺功能的有效性：一项前瞻性干预前后研究

改善患者的依从性对疾病管理和治疗结果具有重要意义。目的探讨药师管理门诊（PMC）对慢性阻塞性肺病（COPD）患者药物治疗管理服务的效果。方法采用前瞻性干预前后对照研究，在上海市三甲医院同济大学附属东医院进行。2019年10月至2023年4月至PMC就诊的PCD（包括COPD）患者纳入本研究。药剂师在初次就诊时对COPD患者进行干预，随后进行3个月的监测。所有患者均接受药物治疗管理服务，并由药师进行药物依从性评估。记录药物相关问题（DRPs），并使用欧洲五维问卷（EQ-5D）评估与健康相关的生活质量（HRQoL）。分析排名前10位的慢性病患者的药物依从性。评估干预前后COPD患者的依从性和肺功能。结果共纳入713例患者，确定drp 768例。平均EQ- 5d效用和EQ视觉模拟量表（EQ- vas）评分分别为0.91±0.17和73.74±14.3。425例患者中，8.5%为高依从性，69%为中等依从性，22.5%为低依从性。值得注意的是，COPD患者中等依从性比例最高，高依从性比例最低。COPD患者干预后，中等依从性比例显著增加，总体依从性和FEV1较干预前有显著改善（p < 0.05）。结论药师有能力评价PCD患者的DRPs、HRQoL和依从性。药师开展药物治疗管理服务可提高COPD患者的依从性，进一步改善COPD患者的肺功能。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of evaluation in clinical practice 医学-卫生保健

CiteScore

4.80

自引率

4.20%

发文量

143

审稿时长

3-8 weeks

期刊介绍： The Journal of Evaluation in Clinical Practice aims to promote the evaluation and development of clinical practice across medicine, nursing and the allied health professions. All aspects of health services research and public health policy analysis and debate are of interest to the Journal whether studied from a population-based or individual patient-centred perspective. Of particular interest to the Journal are submissions on all aspects of clinical effectiveness and efficiency including evidence-based medicine, clinical practice guidelines, clinical decision making, clinical services organisation, implementation and delivery, health economic evaluation, health process and outcome measurement and new or improved methods (conceptual and statistical) for systematic inquiry into clinical practice. Papers may take a classical quantitative or qualitative approach to investigation (or may utilise both techniques) or may take the form of learned essays, structured/systematic reviews and critiques.