Structured pharmacist-led intervention programme to improve medication adherence in COPD patients: a randomized controlled study

Suhaj Abdulsalim, Unnikrishnan Mazhuvancherry Kesavan, Manu K. Mohan, Alian A. Alrasheedy, Brian Godman, Donald E. Morisky

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: COPD, a progressive, partly reversible condition with airflow limitation particularly warrants the inclusion of pharmacists in the healthcare team. Extreme physician scarcity severely limits the implementation of quality healthcare in India. Pharmacist-led educational intervention achieves smoking cessation and improves medication adherence. Objective: This study evaluated the effectiveness of a clinical pharmacist-led intervention on medication adherence in COPD patients in a teaching hospital. Methods: In an open-labelled randomized controlled study at Kasturba Medical College Hospital, Manipal, India, patients were randomly assigned to two groups (Intervention group [IG] and Control group [CG]), and were matched for socio-demographics and clinical characteristics. Medication adherence was assessed by the Morisky, Green and Levine Medication Adherence Questionnaire (MAQ). In IG, pharmacist intervention placed emphasis on (1) compliance, (2) smoking cessation, (3) exercise, (4) inhaler use and (5) need for timely follow up. The MAQ assessment was repeated at 6, 12, 18 and 24 months. Data were analysed statistically by SPSS version 20.0. Results: Out of 328 patients screened during March 2012 to June 2013, 260 were recruited. Of these, 206 completed the follow-up (98 in CG and 104 in IG). Medication adherence improved significantly after pharmacist intervention in IG at all follow-up time points (P<0.001). It increased from 49% at the baseline to 80% after 24 months (P<0.001). Carelessness about taking medicines was one of the main reasons for non-adherence in COPD patients, but was effectively reduced by the intervention. Conclusions: This is the first randomized controlled trial in India that demonstrates the pivotal role of pharmacist-led educational intervention in improving medication adherence in COPD. Involving non-physician health professionals could be the best strategy, for resource-poor nations like India, because the current physician-centric healthcare has no emphasis on patient education and counseling.
LanguageEnglish
Number of pages12
JournalResearch in Social and Administrative Pharmacy
Early online date25 Oct 2017
DOIs
Publication statusE-pub ahead of print - 25 Oct 2017

Fingerprint

Medication Adherence
Pharmacists
Chronic Obstructive Pulmonary Disease
Lead
India
Smoking Cessation
Medicine
Teaching
Education
Health
Physicians
Control Groups
Patient Care Team
Quality of Health Care
Nebulizers and Vaporizers
Patient Education
Teaching Hospitals
Compliance
Counseling
Randomized Controlled Trials

Keywords

  • pharmacist intervention
  • medical adherence
  • COPD patients

Cite this

Abdulsalim, Suhaj ; Kesavan, Unnikrishnan Mazhuvancherry ; Mohan, Manu K. ; Alrasheedy, Alian A. ; Godman, Brian ; Morisky, Donald E. / Structured pharmacist-led intervention programme to improve medication adherence in COPD patients : a randomized controlled study. In: Research in Social and Administrative Pharmacy. 2017.
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abstract = "Background: COPD, a progressive, partly reversible condition with airflow limitation particularly warrants the inclusion of pharmacists in the healthcare team. Extreme physician scarcity severely limits the implementation of quality healthcare in India. Pharmacist-led educational intervention achieves smoking cessation and improves medication adherence. Objective: This study evaluated the effectiveness of a clinical pharmacist-led intervention on medication adherence in COPD patients in a teaching hospital. Methods: In an open-labelled randomized controlled study at Kasturba Medical College Hospital, Manipal, India, patients were randomly assigned to two groups (Intervention group [IG] and Control group [CG]), and were matched for socio-demographics and clinical characteristics. Medication adherence was assessed by the Morisky, Green and Levine Medication Adherence Questionnaire (MAQ). In IG, pharmacist intervention placed emphasis on (1) compliance, (2) smoking cessation, (3) exercise, (4) inhaler use and (5) need for timely follow up. The MAQ assessment was repeated at 6, 12, 18 and 24 months. Data were analysed statistically by SPSS version 20.0. Results: Out of 328 patients screened during March 2012 to June 2013, 260 were recruited. Of these, 206 completed the follow-up (98 in CG and 104 in IG). Medication adherence improved significantly after pharmacist intervention in IG at all follow-up time points (P<0.001). It increased from 49{\%} at the baseline to 80{\%} after 24 months (P<0.001). Carelessness about taking medicines was one of the main reasons for non-adherence in COPD patients, but was effectively reduced by the intervention. Conclusions: This is the first randomized controlled trial in India that demonstrates the pivotal role of pharmacist-led educational intervention in improving medication adherence in COPD. Involving non-physician health professionals could be the best strategy, for resource-poor nations like India, because the current physician-centric healthcare has no emphasis on patient education and counseling.",
keywords = "pharmacist intervention, medical adherence, COPD patients",
author = "Suhaj Abdulsalim and Kesavan, {Unnikrishnan Mazhuvancherry} and Mohan, {Manu K.} and Alrasheedy, {Alian A.} and Brian Godman and Morisky, {Donald E.}",
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Structured pharmacist-led intervention programme to improve medication adherence in COPD patients : a randomized controlled study. / Abdulsalim, Suhaj; Kesavan, Unnikrishnan Mazhuvancherry; Mohan, Manu K.; Alrasheedy, Alian A.; Godman, Brian; Morisky, Donald E.

In: Research in Social and Administrative Pharmacy, 25.10.2017.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Structured pharmacist-led intervention programme to improve medication adherence in COPD patients

T2 - Research in Social and Administrative Pharmacy

AU - Abdulsalim, Suhaj

AU - Kesavan, Unnikrishnan Mazhuvancherry

AU - Mohan, Manu K.

AU - Alrasheedy, Alian A.

AU - Godman, Brian

AU - Morisky, Donald E.

PY - 2017/10/25

Y1 - 2017/10/25

N2 - Background: COPD, a progressive, partly reversible condition with airflow limitation particularly warrants the inclusion of pharmacists in the healthcare team. Extreme physician scarcity severely limits the implementation of quality healthcare in India. Pharmacist-led educational intervention achieves smoking cessation and improves medication adherence. Objective: This study evaluated the effectiveness of a clinical pharmacist-led intervention on medication adherence in COPD patients in a teaching hospital. Methods: In an open-labelled randomized controlled study at Kasturba Medical College Hospital, Manipal, India, patients were randomly assigned to two groups (Intervention group [IG] and Control group [CG]), and were matched for socio-demographics and clinical characteristics. Medication adherence was assessed by the Morisky, Green and Levine Medication Adherence Questionnaire (MAQ). In IG, pharmacist intervention placed emphasis on (1) compliance, (2) smoking cessation, (3) exercise, (4) inhaler use and (5) need for timely follow up. The MAQ assessment was repeated at 6, 12, 18 and 24 months. Data were analysed statistically by SPSS version 20.0. Results: Out of 328 patients screened during March 2012 to June 2013, 260 were recruited. Of these, 206 completed the follow-up (98 in CG and 104 in IG). Medication adherence improved significantly after pharmacist intervention in IG at all follow-up time points (P<0.001). It increased from 49% at the baseline to 80% after 24 months (P<0.001). Carelessness about taking medicines was one of the main reasons for non-adherence in COPD patients, but was effectively reduced by the intervention. Conclusions: This is the first randomized controlled trial in India that demonstrates the pivotal role of pharmacist-led educational intervention in improving medication adherence in COPD. Involving non-physician health professionals could be the best strategy, for resource-poor nations like India, because the current physician-centric healthcare has no emphasis on patient education and counseling.

AB - Background: COPD, a progressive, partly reversible condition with airflow limitation particularly warrants the inclusion of pharmacists in the healthcare team. Extreme physician scarcity severely limits the implementation of quality healthcare in India. Pharmacist-led educational intervention achieves smoking cessation and improves medication adherence. Objective: This study evaluated the effectiveness of a clinical pharmacist-led intervention on medication adherence in COPD patients in a teaching hospital. Methods: In an open-labelled randomized controlled study at Kasturba Medical College Hospital, Manipal, India, patients were randomly assigned to two groups (Intervention group [IG] and Control group [CG]), and were matched for socio-demographics and clinical characteristics. Medication adherence was assessed by the Morisky, Green and Levine Medication Adherence Questionnaire (MAQ). In IG, pharmacist intervention placed emphasis on (1) compliance, (2) smoking cessation, (3) exercise, (4) inhaler use and (5) need for timely follow up. The MAQ assessment was repeated at 6, 12, 18 and 24 months. Data were analysed statistically by SPSS version 20.0. Results: Out of 328 patients screened during March 2012 to June 2013, 260 were recruited. Of these, 206 completed the follow-up (98 in CG and 104 in IG). Medication adherence improved significantly after pharmacist intervention in IG at all follow-up time points (P<0.001). It increased from 49% at the baseline to 80% after 24 months (P<0.001). Carelessness about taking medicines was one of the main reasons for non-adherence in COPD patients, but was effectively reduced by the intervention. Conclusions: This is the first randomized controlled trial in India that demonstrates the pivotal role of pharmacist-led educational intervention in improving medication adherence in COPD. Involving non-physician health professionals could be the best strategy, for resource-poor nations like India, because the current physician-centric healthcare has no emphasis on patient education and counseling.

KW - pharmacist intervention

KW - medical adherence

KW - COPD patients

UR - http://www.sciencedirect.com/science/journal/15517411

U2 - 10.1016/j.sapharm.2017.10.008

DO - 10.1016/j.sapharm.2017.10.008

M3 - Article

JO - Research in Social and Administrative Pharmacy

JF - Research in Social and Administrative Pharmacy

SN - 1551-7411

ER -