scholarly journals Impact of clinical pharmacist intervention in chronic obstructive pulmonary disease management

2020 ◽  
Vol 8 (11) ◽  
pp. 3944
Author(s):  
Jackin R. Moses ◽  
Neena Priyamalar E. M. ◽  
Shilpa Ravi ◽  
Raveena Pachal Balakrishnan ◽  
Rajganesh Ravichandran ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Medication Adherence ◽  
Clinical Pharmacist ◽  
Pharmacist Intervention ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Study Participants ◽  
The Impact ◽  
Improve Patient ◽  
Clinical Pharmacist Intervention

Background: Chronic obstructive pulmonary disease (COPD) is a common, preventable, and treatable disease characterized by persistent respiratory symptoms and airflow limitation. In 2016, COPD is the third leading cause of death globally and is projected to increase by more than 30% in the next 10 years. The main threat to the prognosis lies in the lack of disease knowledge, poor medication adherence, and health-related quality of life. Clinical Pharmacist is a key profession to improve patient care in COPD management and literature in this regard is very limited. It is important to establish the impact of a clinical pharmacist as an indicator to improve patient outcomes. Hence the aim of this was to assess the Impact of Clinical Pharmacist Intervention in COPD management in a Tertiary care hospital.Methods: The study was conducted as a prospective and interventional. A total of 53 patients were recruited in the study. The study participants were educated by a clinical pharmacist on disease state, medications, and breathing techniques. Patients have a regular follow-up after 6 months during a scheduled visit. Questionnaires were administered to all patients at baseline and 6 months to assess their medication adherence, disease-related knowledge, and HRQoL.Results: Out of 53 study participants, the majority of COPD patients 23 (46.94%) were found to be in the elderly age group of 60-69 years. The majority of the patients were in a severe category of 48.98%. Thereafter intervention assessment of COPD related knowledge showed a 33.45% improvement. The majority of study participants showed high adherence after the intervention of 46.94 %. All aspects of the HRQoL questionnaire showed improvement after intervention. The results were statistically significant.  Conclusions: The Pharmacist-led COPD Intervention showed improvement in the three main aspects of the study. It confirms the need for healthcare systems to recognize the role of clinical pharmacists in both pharmacological therapy and non-pharmacological supportive care.

scholarly journals Impact of a Clinical Pharmacist Intervention on Medicine Costs in Patients with Chronic Obstructive Pulmonary Disease in India

2019 ◽  
Vol 4 (2) ◽  
pp. 331-342 ◽  
Author(s):  
Suhaj Abdulsalim ◽  
Mazhuvancherry Kesavan Unnikrishnan ◽  
Mohan K. Manu ◽  
Saud Alsahali ◽  
Alian A. Alrasheedy ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Clinical Pharmacist ◽  
Pharmacist Intervention ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Clinical Pharmacist Intervention

scholarly journals IMPACT OF PATIENT COUNSELING ON HEALTH KNOWLEDGE AND MEDICATION ADHERENCE IN ASTHMA AND CHRONIC OBSTRUCTIVE PULMONARY DISEASE PATIENTS

2020 ◽  
pp. 183-186
Author(s):  
UNNATI P ◽  
ANUSHREYA S ◽  
GABRIELA KEERTHANA G ◽  
MOUNICA P
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Medication Adherence ◽  
Pulmonary Disease ◽  
Clinical Pharmacist ◽  
Health Knowledge ◽  
Chronic Obstructive ◽  
Patient Counseling ◽  
Obstructive Pulmonary Disease ◽  
Patient Responses ◽  
The Impact

Objective: This study evaluated the impact of clinical pharmacist-led intervention in health knowledge and medication adherence of Asthma and chronic obstructive pulmonary disease (COPD) patients. Methods: Questionnaires were designed to assess Health knowledge for Asthma and COPD separately. Medication adherence was measured by using the Morisky Medication Adherence Scale-8. Pre-counseling patient responses were recorded. Patient counseling was given regarding the disease condition, medications, and medication use at baseline visit. Patient responses were re-measured upon follow-up visit. The data extracted were tabulated, statistically analyzed and the results were obtained. Results: A total of 141 patients completed the study. Before counseling, the mean (±standard deviation) of knowledge and adherence levels were found to be 8.51±3.36 and 5.01±2.11, respectively. After counseling, they increased up to 12.72±2.16 for knowledge (p<0.0001) and 6.60±1.35 (p<0.0001) for medication adherence. The majority of subjects had about 11–30% increase in knowledge as well as medication adherence. Male patients were more adherent to their medication regime than females. Conclusion: The study demonstrates the positive impact of education and counseling provided by a clinical pharmacist in achieving better therapeutic outcomes – through improvement in medication adherence and health knowledge. In conclusion, continuous education programs and patient counseling should be conducted for chronic diseases to reiterate the importance of medication adherence and, in turn, prevent recurrences, arrest disease progression, minimize hospitalization, and ultimately improve quality of life.

scholarly journals The Consequences of General Medication Beliefs Measured by the Beliefs about Medicine Questionnaire on Medication Adherence: A Systematic Review

Pharmacy ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 147
Author(s):  
Wejdan Shahin ◽  
Gerard A. Kennedy ◽  
Ieva Stupans
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Medication Adherence ◽  
Pulmonary Disease ◽  
Negative Association ◽  
Chronic Illnesses ◽  
Chronic Obstructive ◽  
Cultural Backgrounds ◽  
Obstructive Pulmonary Disease ◽  
Medication Beliefs ◽  
The Impact

(1) Background: Medication adherence is a key determinant of patient health outcomes in chronic illnesses. However, adherence to long-term therapy remains poor. General beliefs about medicine are considered factors influencing medication adherence. It is essential to address the gap in the literature regarding understanding the impact of general beliefs about medicine on medication adherence to promote adherence in chronic illnesses. (2) Methods: PubMed, CINHAL, and EMBASE databases were searched. Studies were included if they examined medication beliefs using the Beliefs about Medicine Questionnaire in one of four chronic illnesses: hypertension, diabetes, chronic obstructive pulmonary disease, and/or asthma. (3) Results: From 1799 articles obtained by the search, only 11 met the inclusion criteria. Hypertension and diabetes represented 91% of included studies, while asthma represented 9%. Higher medication adherence was associated with negative general medication beliefs; 65% of the included studies found a negative association between harm beliefs and adherence, while 30% of studies found a negative association with overuse beliefs. (4) Conclusions: This review evaluated the impact of harm and overuse beliefs about medicines on medication adherence, highlighting the gap in literature regarding the impact of harm and overuse beliefs on adherence. Further research is needed to fully identify the association between general beliefs and medication adherence in people with different cultural backgrounds, and to explore these beliefs in patients diagnosed with chronic illnesses, particularly asthma and chronic obstructive pulmonary disease (COPD). Healthcare providers need to be aware of the impact of patients’ cultural backgrounds on general medication beliefs and adherence.

scholarly journals ‘I’m fine!’: Assertions of lack of support need among patients with chronic obstructive pulmonary disease: A mixed-methods study

2021 ◽  
pp. 174239532110003
Author(s):  
A Carole Gardener ◽  
Caroline Moore ◽  
Morag Farquhar ◽  
Gail Ewing ◽  
Efthalia Massou ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Mixed Method ◽  
Self Report ◽  
Design Stage ◽  
Chronic Obstructive ◽  
Support Needs ◽  
Obstructive Pulmonary Disease ◽  
Stage 1 ◽  
The Impact

Objectives To understand how people with Chronic Obstructive Pulmonary Disease (COPD) disavow their support needs and the impact on care. Methods Two stage mixed-method design. Stage 1 involved sub-analyses of data from a mixed-method population-based longitudinal study exploring the needs of patients with advanced COPD. Using adapted criteria from mental health research, we identified 21 patients who disavowed their needs from the 235 patient cohort. Qualitative interview transcripts and self-report measures were analysed to compare these patients with the remaining cohort. In stage 2 focus groups (n = 2) with primary healthcare practitioners (n = 9) explored the implications of Stage 1 findings. Results Patients who disavowed their support needs described non-compliance with symptom management and avoidance of future care planning (qualitative data). Analysis of self-report measures of mental and physical health found this group reported fewer needs than the remaining sample yet wanted more GP contact. The link between risk factors and healthcare professional involvement present in the rest of the sample was missing for these patients. Focus group data suggested practitioners found these patients challenging. Discussion This study identified patients with COPD who disavow their support needs, but who also desire more GP contact. GPs report finding these patients challenging to engage.

scholarly journals Time-to-first exacerbation, adherence, and medical costs among US patients receiving umeclidinium/vilanterol or tiotropium as initial maintenance therapy for chronic obstructive pulmonary disease: a retrospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
David Slade ◽  
Riju Ray ◽  
Chad Moretz ◽  
Guillaume Germain ◽  
François Laliberté ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Cohort Study ◽  
Medication Adherence ◽  
Index Date ◽  
Medical Costs ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Maintenance Medication ◽  
Kaplan Meier ◽  
Long Acting

Abstract Background Adherence to chronic obstructive pulmonary disease (COPD) maintenance medication is important for managing symptoms and exacerbation risk, and is associated with reduced mortality, hospitalizations, and costs. This study compared on-treatment exacerbations, medical costs, and medication adherence in patients with COPD initiating treatment with umeclidinium/vilanterol (UMEC/VI) or tiotropium (TIO). Methods This retrospective matched cohort study selected patients from Optum’s de-identified Clinformatics Data Mart database who initiated maintenance treatment with UMEC/VI or TIO between 01/01/2014 and 12/31/2017 (index date defined as the first dispensing). Eligible patients were ≥ 40 years of age and had ≥ 12 months continuous health plan coverage pre- and post-index; ≥ 1 medical claim for COPD pre-index or on the index date; no moderate/severe COPD-related exacerbations on the index date; no asthma diagnosis pre- or post-index; no maintenance medication fills containing inhaled corticosteroids, long-acting β2-agonists, or long-acting muscarinic antagonists pre-index or on the index date; and no fills for both UMEC/VI and TIO on the index date. Outcomes included time-to-first (Kaplan–Meier analysis) and rates of on-treatment COPD-related moderate/severe exacerbations, medication adherence (proportion of days covered [PDC] and proportion of adherent patients [PDC ≥ 0.8]), and COPD-related medical costs per patient per month (PPPM). Propensity score matching was used to adjust for potential confounders. Results Each cohort included 3929 matched patients. Kaplan–Meier rates of on-treatment COPD-related exacerbations were similar between cohorts (hazard ratio at 12 months; overall: 0.93, moderate: 0.92, severe: 1.07; all p > 0.05). UMEC/VI versus TIO initiators had significantly higher adherence (mean PDC: 0.44 vs 0.37; p < 0.001; proportion with PDC ≥ 0.8: 22.0% vs 16.4%; p< 0.001) and significantly lower mean on-treatment COPD-related total medical costs ($867 vs $1095 PPPM; p = 0.028), driven by lower outpatient visit costs. Conclusions These findings provide valuable information for physicians considering UMEC/VI or TIO as initial maintenance therapy options for patients with COPD.

scholarly journals The impact of age on outcomes in chronic obstructive pulmonary disease differs by relationship status

2013 ◽  
Vol 37 (4) ◽  
pp. 654-663 ◽  
Author(s):  
Kristen E. Holm ◽  
Melissa R. Plaufcan ◽  
Dee W. Ford ◽  
Robert A. Sandhaus ◽  
Matthew Strand ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Relationship Status ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
The Impact

The impact of virtual admission on self-efficacy in patients with chronic obstructive pulmonary disease - a randomised clinical trial

2014 ◽  
Vol 23 (21-22) ◽  
pp. 3124-3137 ◽  
Author(s):  
Christina Emme ◽  
Erik L Mortensen ◽  
Susan Rydahl-Hansen ◽  
Birte Østergaard ◽  
Anna Svarre Jakobsen ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Clinical Trial ◽  
Pulmonary Disease ◽  
Self Efficacy ◽  
Randomised Clinical Trial ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
The Impact

Abstract 15226: The Impact of Chronic Obstructive Pulmonary Disease on In-hospital Outcomes Following Left Ventricular Assist Device Implantation

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Bertrand Ebner ◽  
Jennifer Maning ◽  
Louis Vincent ◽  
Jelani Grant ◽  
neal olarte ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Left Ventricular Assist Device ◽  
Left Ventricular ◽  
Chronic Obstructive ◽  
Assist Device ◽  
Hospital Outcomes ◽  
Ventricular Assist ◽  
Obstructive Pulmonary Disease ◽  
Left Ventricular Assist ◽  
The Impact

Background: Chronic obstructive pulmonary disease (COPD) is well-known cause of ventricular dysfunction. However, in the setting of patients with advanced heart failure undergoing left ventricular assist device (LVAD) implantation, there is paucity data on COPD influence on in-hospital outcomes. Methods: This retrospective cohort study based on the Nationwide Inpatient Sample included all patients above 18 years all who underwent LVAD implantation from 2011 to 2017. All data was weight as recommended by Healthcare Cost and Utilization Project.Multivariate logistic regression was used to evaluate the impact of COPD on in-hospital outcomes. Results: A total of 25,503 patients underwent LVAD implantation, of those 13.8% had a pre-existing diagnosis of COPD. Individuals with COPD were older (median 62 vs. 58 years, p<0.001), more commonly male (82% vs. 76.4%, p<0.001). Patient with COPD had a greater burden of comorbidities confirmed by significant higher rate of hypertension, diabetes, atrial tachyarrhythmias, dyslipidemia, prior stroke, coronary and peripheral artery diseases, pulmonary hypertension, and chronic kidney disease (p<0.001 for all). No significant difference was found in in-hospital stroke, infections, short-term percutaneous mechanical circulatory support, implant related complications, and LVAD thrombosis. There was a significant higher rate of inpatient acute kidney injury, major bleeding, cardiac complications, thromboembolism, and cardiac arrest in patients without COPD (p<0.05 for all outcomes). Compared to patients without COPD, individuals with COPD had a lower mortality (6.2% vs. 12.4%; OR 0.59; C.I. 0.512-0.685; p<0.05). Conclusion: Patients with COPD undergoing LVAD implantation have higher comorbidities, however, it is not associated with increase in-hospital all-cause mortality.Further studies are needed to analyze the differences found between these two groups in more detail.

The state of the cardiovascular system in occupational bronchitis and chronic obstructive pulmonary disease, not associated with the impact of harmful industrial factors

2021 ◽  
pp. 55-68
Author(s):  
Vyacheslav S. Lotkov ◽  
Anton Vladimirovich Glazistov ◽  
Antonina G. Baykova ◽  
Marina Yuryevna Vostroknutova ◽  
Natalia E. Lavrentieva
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Cardiovascular System ◽  
Pulmonary Disease ◽  
Lung Diseases ◽  
Chronic Obstructive ◽  
External Respiration ◽  
Obstructive Pulmonary Disease ◽  
Occupational Lung Diseases ◽  
The Right ◽  
The Impact

The formation and progression of chronic dust bronchitis and chronic bronchitis of toxic-chemical etiology, chronic obstructive pulmonary disease is accompanied by an increase in the degree of ventilation disorders, echocardiographic signs of hypertrophy and dilatation of the right ventricle are formed, typical for chronic pulmonary heart disease. The progression of disturbances in the function of external respiration in dusty lung diseases leads to a decrease in myocardial contractility. The detection of hemodynamic disturbances at the early stages of the development of occupational lung diseases indicates the need for individual monitoring of the functional state of the cardiovascular system in the process of contact with industrial aerosols, especially in groups of workers with long-term exposure.

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