title: An evaluation of a multi-site community pharmacy-based chronic obstructive pulmonary disease support service.
abstract: OBJECTIVE
  Chronic obstructive pulmonary disease (COPD) is a progressive chronic condition that can be effectively managed by smoking-cessation, optimising prescribed therapy and providing treatment to prevent chest infections from causing hospitalisation. The government agenda in the UK is for community pharmacists to become involved in chronic disease management, and COPD is one area where they are ideally located to provide a comprehensive service. This study aims to evaluate the effect of a community pharmacy-based COPD service on patient outcomes.
  
  
  METHODS
  Patients in one UK location were recruited over a 10-week period to receive a community pharmacy-based COPD support service consisting of signposting to or provision of smoking-cessation service, therapy optimisation and recommendation to obtain a rescue pack containing steroid and antibiotic to prevent hospitalisation as a result of chest infection. Data were collected over a 6-month period for all recruited patients. Appropriate clinical outcomes, patient reported medication adherence, quality of life and National Health Service (NHS) resource utilisation were measured.
  
  
  RESULTS
  Three hundred six patients accessed the service. Data to enable comparison before and after intervention was available for 137 patients. Significant improvements in patient reported adherence, utilisation of rescue packs, quality of life and a reduction in routine general practitioner (GP) visits were identified. The intervention cost was estimated to be off-set by reductions in the use of other NHS services (GP and accident and emergency visits and hospital admissions).
  
  
  CONCLUSIONS
  Results suggest that the service improved patient medicine taking behaviours and that it was cost-effective.
authors.affiliation: School of Pharmacy, University of East Anglia, Norwich, UK.
authors.forename: David
authors.initials: D
authors.lastname: Wright
authors.forename: Michael
authors.initials: M
authors.lastname: Twigg
authors.forename: Garry
authors.initials: G
authors.lastname: Barton
authors.forename: Tracey
authors.initials: T
authors.lastname: Thornley
authors.forename: Clare
authors.initials: C
authors.lastname: Kerr
mesh_terms: D000368:Aged; D003157:Community Pharmacy Services / Q000191:economics / Q000706:statistics & numerical data*; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care / Q000191:economics*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D029424:Pulmonary Disease, Chronic Obstructive / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology; D016903:Drug Monitoring
keywords: adherence; chronic obstructive pulmonary disease; community pharmacy; economic evaluation; quality of life