title: Effectiveness of pharmaceutical care for patients with chronic obstructive pulmonary disease (PHARMACOP): a randomized controlled trial.
abstract: OBJECTIVE
  Few well-designed randomized controlled trials have been conducted regarding the impact of community pharmacist interventions on pharmacotherapeutic monitoring of patients with chronic obstructive pulmonary disease (COPD). We assessed the effectiveness of a pharmaceutical care programme for patients with COPD.
  
  
  METHODS
  The pharmaceutical care for patients with COPD (PHARMACOP) trial is a single-blind 3 month randomized controlled trial, conducted in 170 community pharmacies in Belgium, enrolling patients prescribed daily COPD medication, aged ≥ 50 years and with a smoking history of ≥ 10 pack-years. A computer-generated randomization sequence allocated patients to an intervention group (n = 371), receiving protocol-defined pharmacist care, or a control group (n = 363), receiving usual pharmacist care (1:1 ratio, stratified by centre). Interventions focusing on inhalation technique and adherence to maintenance therapy were carried out at start of the trial and at 1 month follow-up. Primary outcomes were inhalation technique and medication adherence. Secondary outcomes were exacerbation rate, dyspnoea, COPD-specific and generic health status and smoking behaviour.
  
  
  RESULTS
  From December 2010 to April 2011, 734 patients were enrolled. Forty-two patients (5.7%) were lost to follow-up. At the end of the trial, inhalation score [mean estimated difference (Δ),13.5%; 95% confidence interval (CI), 10.8-16.1; P < 0.0001] and medication adherence (Δ, 8.51%; 95% CI, 4.63-12.4; P < 0.0001) were significantly higher in the intervention group compared with the control group. In the intervention group, a significantly lower hospitalization rate was observed (9 vs. 35; rate ratio, 0.28; 95% CI, 0.12-0.64; P = 0.003). No other significant between-group differences were observed.
  
  
  CONCLUSIONS
  Pragmatic pharmacist care programmes improve the pharmacotherapeutic regimen in patients with COPD and could reduce hospitalization rates.
authors.affiliation: Pharmaceutical Care Unit, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium.
authors.forename: Eline
authors.initials: E
authors.lastname: Tommelein
authors.forename: Els
authors.initials: E
authors.lastname: Mehuys
authors.forename: Thierry
authors.initials: T
authors.lastname: Van Hees
authors.forename: Els
authors.initials: E
authors.lastname: Adriaens
authors.forename: Luc
authors.initials: L
authors.lastname: Van Bortel
authors.forename: Thierry
authors.initials: T
authors.lastname: Christiaens
authors.forename: Inge
authors.initials: I
authors.lastname: Van Tongelen
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Remon
authors.forename: Koen
authors.initials: K
authors.lastname: Boussery
authors.forename: Guy
authors.initials: G
authors.lastname: Brusselle
mesh_terms: D000368:Aged; D003157:Community Pharmacy Services; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000188:drug therapy*; D016037:Single-Blind Method
keywords: adherence; chronic obstructive pulmonary disease; exacerbation; inhalation therapy; pharmacist care