People with asthma or COPD often struggle to use their inhalers correctly. This matters because poor technique means the medicine never reaches the lungs where it is needed. A large review looked at 4173 patients to see if pharmacist involvement could fix this problem. The answer was a clear yes. Patients who received pharmaceutical care from pharmacists showed significantly better inhaler technique. The odds of using the device correctly were much higher in this group compared to those who received standard treatment only. They also took their medicine more consistently. This improved adherence helped them manage their breathing issues better. The review also found that these patients had fewer emergency room visits and hospital admissions. This suggests that getting help from a pharmacist can keep people out of the hospital. While some measures like quality of life scores did not change significantly, the improvements in technique and safety are important. The study noted that better research designs are still needed to fully understand these benefits. However, the current evidence supports the value of pharmacist support for these patients.
Meta-analysis shows pharmaceutical care improves asthma and COPD management outcomes in 4173 patientsPharmacist care improves asthma and COPD control and reduces hospital visits
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Key Takeaway
Pharmaceutical care interventions show positive effects on asthma and COPD management outcomes in this meta-analysis.
This meta-analysis examined the impact of pharmaceutical care interventions compared to original treatment only in a population of 4173 asthma or COPD patients. The study synthesized data on multiple outcomes including the Asthma Control Test, COPD Assessment Test, and modified Medical Research Council dyspnea scale. Secondary outcomes covered medication adherence, inhaler technique, emergency room visits, hospitalization, asthma quality of life, and peak expiratory flow rate.
The analysis reported that the correct inhalation technique rate was significantly better in the pharmaceutical care group with an odds ratio of 6.53 and a 95% confidence interval of [3.19, 13.37]. Medication adherence was also significantly better with an odds ratio of 1.45 and a 95% confidence interval of [1.03, 2.03]. Better asthma control was indicated by ACT results with an odds ratio of 2.51 and a 95% confidence interval of [2.51, 4.35].
Adverse events, serious adverse events, discontinuations, and tolerability were not reported. The emergency room visit rate was significantly lower with an odds ratio of 0.44 and a 95% confidence interval of [0.29, 0.67]. Hospital admissions were significantly lower with an odds ratio of 0.27 and a 95% confidence interval of [0.19, 0.39]. Peak expiratory flow rate showed improvement with a standardized mean difference of 0.37 and a 95% confidence interval of [0.09, 0.6]. No significant changes were observed for CAT, AQLQ, or mMRC. The authors state that improved research design and quality are still needed.
What this means for you:
Pharmacist care improves inhaler use and reduces hospital visits for asthma and COPD patients. More on Chronic Obstructive Pulmonary Disease
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View Original Abstract ↓
PURPOSE: This meta-analysis aimed to evaluate the effectiveness of pharmaceutical care in managing asthma and chronic obstructive pulmonary disease (COPD), focusing on clinical outcomes, medication adherence, and quality of life.
PATIENTS AND METHODS: Randomized controlled trials comparing asthma or COPD patients who received pharmaceutical care intervention on the basis of the original treatment and the control group who only received the original treatment were included. The main results include Asthma Control Test (ACT); COPD Assessment Test (CAT); modified Medical Research Council (mMRC) dyspnea scale. Secondary outcomes were medication adherence; correct rate of inhaler technique; emergency room visit; hospitalization; Asthma Quality of Life Questionnaire (AQLQ); Peak Expiratory Flow Rate (PEFR, L/min). All analyses used a random - effects model.
RESULTS: A total of 18 randomized controlled trials involving 4173 patients were included. The results showed that in the pharmaceutical care group, the mean correct inhalation technique rate (OR = 6.53, 95% CI: [3.19, 13.37], P < 0.001), medication adherence (OR = 1.45, 95% CI: [1.03, 2.03], P = 0.031), and the number of patients with better asthma control as indicated by ACT results (OR = 2.51, 95% CI: [2.51, 4.35], P < 0.01) were significantly better than those in the control group. The emergency room visit rate (OR = 0.44, 95% CI: [0.29, 0.67], P < 0.001) and hospital admissions rate (OR = 0.27, 95% CI: [0.19, 0.39], P < 0.001) were significantly lower. The PEFR of patients was better (SMD = 0.37, 95% CI: [0.09, 0.6], P < 0.01). However, no significant changes were observed in CAT, AQLQ, or mMRC.
CONCLUSION: Pharmacists' interventions exert a positive effect on asthma and COPD management outcomes, though improved research design and quality are still needed.
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