[Management of COPD in community pharmacy].
BACKGROUND
This observational study aimed to provide a detailed description of (i) drug therapy, (ii) drug adherence, (iii) inhalation technique, and (iv) health status of COPD patients recruited via community pharmacies. Based on these results, problem areas can be detected and targeted pharmacist interventions for improvement of COPD management could be developed.


METHODS
We conducted a cross-sectional, observational study in 93 pharmacies (Belgium). Participants (n = 555) completed a questionnaire collecting personal characteristics, smoking history, influenza vaccination, COPD medication and side effects. Adherence to COPD maintenance medication was analysed 1 year-retrospectively through prescription refill rates. Inhalation technique was scored using a checklist.


RESULTS
The COPD patients had a mean age of 68.6 yr, 73.7% were men and 37.2% were current smokers. The influenza vaccination status was significantly lower in patients aged < 65 yr (65.7%) than in patients aged > or = 65 years (86.2%) (p < 0.001). Fixed combinations of inhaled corticosteroids and long-acting beta2-agonists were the most frequently used COPD medications (75.4%). About 48% of patients was underadherent (< 80% adherence), 47% was adherent (80-120% adherence) and 5% was overadherent (> 120% adherence). Twenty-one % of patients made major inhalation technique errors with rescue medication; these were all errors in handling pressurized metered dose inhalers (pMDI's).


CONCLUSIONS
This study on COPD management in primary care highlights 4 main aspects which could be improved: (i) drug adherence, (ii) inhalation technique with pMDI's, (iii) influenza vaccination in COPD patients < yr and (iv) smoking cessation.
Mehuys
E
E
Laboratorium voor Farmaceutische Technologie, Faculteit Farmaceutische Wetenschappen (UGent), Gent. els.mehuys@ugent.be
Boussery
K
K
Adriaens
E
E
Van Bortel
L
L
De Bolle
L
L
Van Tongelen
I
I
Remon
J P
JP
Brusselle
G
G
D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003157:Community Pharmacy Services; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology