title: The impact of pharmacist-managed clinic on medication adherence and health-related quality of life in patients with COPD: a randomized controlled study.
abstract: BACKGROUND
  COPD is rapidly becoming one of the most challenging health problems worldwide, which is characterized by not fully reversible airflow limitation. Although a lot of treatment medications have been delivered, the treatment goals of COPD are often not achieved. Furthermore, few well-designed randomized controlled trials in the People's Republic of China have been reported to evaluate the impact of pharmacist-managed clinic (PMC) on medication adherence and health-related quality of life in patients with COPD.
  
  
  METHODS
  A prospective randomized controlled study (on a PMC group and a control group) was conducted between January 2015 and December 2015. A structured education about COPD was provided by a clinical pharmacist to the PMC group. Primary outcomes were medication adherence (assessed by medication refill adherence scores) and health-related quality of life (assessed by St George's Respiratory Questionnaire). Secondary outcomes were exacerbation rate, hospitalization rate, and smoking behavior.
  
  
  RESULTS
  A total of 244 patients were enrolled for our study. The PMC group showed a significantly greater improvement in medication adherence compared with the baseline (93.1±14.2 vs 78.8±12.3, P<0.01). When compared with the control group, there were more patients whose medication refill adherence score was ≥80 in the PMC group (83.3% vs 51.3%, P<0.01). The total St George's Respiratory Questionnaire scores was found to be improved significantly in the PMC group (42.7±3.2 vs 52.4±5.2, P<0.05). There was a lower hospitalization rate in the PMC group, and more patients in the PMC group quit smoking (71.0% vs 52.2%, P<0.05).
  
  
  CONCLUSIONS
  The PMC may result in improvement of medication adherence and the health-related quality of life in patients with COPD. In the PMC group, a significant reduction in exacerbation rate, hospitalization rate, and smoking behavior was observed; therefore, our study provides support for a greater involvement of PMC in the care of patients with COPD.
authors.affiliation: Department of Pharmacy, Zhejiang Academy of Traditional Chinese Medicine, Tongde Hospital of Zhejiang Province, Hangzhou, People's Republic of China.
authors.forename: Chuanwei
authors.initials: C
authors.lastname: Xin
authors.affiliation: Department of Pharmacy, Zhejiang Academy of Traditional Chinese Medicine, Tongde Hospital of Zhejiang Province, Hangzhou, People's Republic of China.
authors.forename: Zhongni
authors.initials: Z
authors.lastname: Xia
authors.affiliation: Department of Pharmacy, Zhejiang Academy of Traditional Chinese Medicine, Tongde Hospital of Zhejiang Province, Hangzhou, People's Republic of China.
authors.forename: Cheng
authors.initials: C
authors.lastname: Jiang
authors.affiliation: Department of Pharmacy, Zhejiang Academy of Traditional Chinese Medicine, Tongde Hospital of Zhejiang Province, Hangzhou, People's Republic of China.
authors.forename: Mengmeng
authors.initials: M
authors.lastname: Lin
authors.affiliation: Department of Pharmacy, Zhejiang Academy of Traditional Chinese Medicine, Tongde Hospital of Zhejiang Province, Hangzhou, People's Republic of China.
authors.forename: Gonghua
authors.initials: G
authors.lastname: Li
keywords: COPD; St George’s Respiratory Questionnaire; medication adherence; pharmacist-managed clinic; smoking status