COPD management in primary care: an observational, community pharmacy-based study.
Identifieur interne : 000077 ( Main/Corpus ); précédent : 000076; suivant : 000078COPD management in primary care: an observational, community pharmacy-based study.
Auteurs : Els Mehuys ; Koen Boussery ; Els Adriaens ; Luc Van Bortel ; Leen De Bolle ; Inge Van Tongelen ; Jean-Paul Remon ; Guy BrusselleSource :
- The Annals of pharmacotherapy [ 1542-6270 ] ; 2010.
English descriptors
- KwdEn :
- Administration, Inhalation, Aerosols, Aged, Aged, 80 and over, Belgium, Community Pharmacy Services, Cross-Sectional Studies, Female, Humans, Influenza Vaccines (administration & dosage), Male, Medication Adherence, Medication Errors, Metered Dose Inhalers, Middle Aged, Pharmaceutical Preparations (administration & dosage), Primary Health Care, Pulmonary Disease, Chronic Obstructive (drug therapy), Retrospective Studies, Smoking (epidemiology), Surveys and Questionnaires.
- MESH :
- chemical , administration & dosage : Influenza Vaccines, Pharmaceutical Preparations.
- chemical : Aerosols.
- geographic : Belgium.
- drug therapy : Pulmonary Disease, Chronic Obstructive.
- epidemiology : Smoking.
- Administration, Inhalation, Aged, Aged, 80 and over, Community Pharmacy Services, Cross-Sectional Studies, Female, Humans, Male, Medication Adherence, Medication Errors, Metered Dose Inhalers, Middle Aged, Primary Health Care, Retrospective Studies, Surveys and Questionnaires.
Abstract
BACKGROUND
Chronic obstructive pulmonary disease (COPD) is a prevalent disease that is frequently treated in primary care. However, data regarding the primary care management of COPD are scarce. Such observational data are necessary to detect problem areas and to develop targeted interventions for improvement of COPD management.
OBJECTIVE
To provide a detailed description of (1) drug therapy, (2) drug adherence, (3) inhalation technique, and (4) health status of patients with COPD recruited via community pharmacies.
METHODS
A cross-sectional, observational study was conducted in 93 pharmacies in Belgium. Participants (N = 555) completed a questionnaire collecting information on personal characteristics, smoking history, influenza vaccination, COPD medication, and adverse effects. Adherence to COPD maintenance medication was analyzed 1 year retrospectively through prescription refill rates. Inhalation technique was scored using a checklist. Health status was evaluated with the St. George's Respiratory Questionnaire, the Clinical COPD Questionnaire, and the Modified Medical Research Council dyspnea scale.
RESULTS
The mean age of the patients was 68.6 years; 73.7% were men and 37.2% were current smokers. The influenza vaccination status was significantly lower in patients aged less than 65 years (65.7%) than in patients aged 65 years or more (86.2%) (p < 0.001). Fixed combinations of inhaled corticosteroids and long-acting beta(2)-agonists were the most frequently used COPD medications (75.4%). About 48% of patients were underadherent (<80% adherence), 47% were adherent (80-120% adherence) and 5% were overadherent (>120% adherence). Predictors for underadherence were age and number of drugs. Twenty-one percent of patients made major inhalation technique errors with rescue medication; these were all errors in handling pressurized metered-dose inhalers (pMDIs).
CONCLUSIONS
This observational study on COPD management in primary care highlights 4 main aspects that could be improved: (1) drug adherence, (2) inhalation technique with pMDIs, (3) influenza vaccination in COPD patients younger than 65 years, and (4) smoking cessation.
DOI: 10.1345/aph.1M481
PubMed: 20103611
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Bolle</name></author><author><name sortKey="Van Tongelen, Inge" sort="Van Tongelen, Inge" uniqKey="Van Tongelen I" first="Inge" last="Van Tongelen">Inge Van Tongelen</name></author><author><name sortKey="Remon, Jean Paul" sort="Remon, Jean Paul" uniqKey="Remon J" first="Jean-Paul" last="Remon">Jean-Paul Remon</name></author><author><name sortKey="Brusselle, Guy" sort="Brusselle, Guy" uniqKey="Brusselle G" first="Guy" last="Brusselle">Guy Brusselle</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2010">2010</date><idno type="RBID">pubmed:20103611</idno><idno type="pmid">20103611</idno><idno type="doi">10.1345/aph.1M481</idno><idno type="wicri:Area/Main/Corpus">000077</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000077</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">COPD management in primary care: an observational, community pharmacy-based study.</title><author><name sortKey="Mehuys, Els" sort="Mehuys, Els" uniqKey="Mehuys E" first="Els" last="Mehuys">Els Mehuys</name><affiliation><nlm:affiliation>Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium. els.mehuys@ugent.be</nlm:affiliation></affiliation></author><author><name sortKey="Boussery, Koen" sort="Boussery, Koen" uniqKey="Boussery K" first="Koen" last="Boussery">Koen Boussery</name></author><author><name sortKey="Adriaens, Els" sort="Adriaens, Els" uniqKey="Adriaens E" first="Els" last="Adriaens">Els Adriaens</name></author><author><name sortKey="Van Bortel, Luc" sort="Van Bortel, Luc" uniqKey="Van Bortel L" first="Luc" last="Van Bortel">Luc Van Bortel</name></author><author><name sortKey="De Bolle, Leen" sort="De Bolle, Leen" uniqKey="De Bolle L" first="Leen" last="De Bolle">Leen De Bolle</name></author><author><name sortKey="Van Tongelen, Inge" sort="Van Tongelen, Inge" uniqKey="Van Tongelen I" first="Inge" last="Van Tongelen">Inge Van Tongelen</name></author><author><name sortKey="Remon, Jean Paul" sort="Remon, Jean Paul" uniqKey="Remon J" first="Jean-Paul" last="Remon">Jean-Paul Remon</name></author><author><name sortKey="Brusselle, Guy" sort="Brusselle, Guy" uniqKey="Brusselle G" first="Guy" last="Brusselle">Guy Brusselle</name></author></analytic><series><title level="j">The Annals of pharmacotherapy</title><idno type="eISSN">1542-6270</idno><imprint><date when="2010" type="published">2010</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Administration, Inhalation</term><term>Aerosols</term><term>Aged</term><term>Aged, 80 and over</term><term>Belgium</term><term>Community Pharmacy Services</term><term>Cross-Sectional Studies</term><term>Female</term><term>Humans</term><term>Influenza Vaccines (administration & dosage)</term><term>Male</term><term>Medication Adherence</term><term>Medication Errors</term><term>Metered Dose Inhalers</term><term>Middle Aged</term><term>Pharmaceutical Preparations (administration & dosage)</term><term>Primary Health Care</term><term>Pulmonary Disease, Chronic Obstructive (drug therapy)</term><term>Retrospective Studies</term><term>Smoking (epidemiology)</term><term>Surveys and Questionnaires</term></keywords><keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Influenza Vaccines</term><term>Pharmaceutical Preparations</term></keywords><keywords scheme="MESH" type="chemical" xml:lang="en"><term>Aerosols</term></keywords><keywords scheme="MESH" type="geographic" xml:lang="en"><term>Belgium</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Pulmonary Disease, Chronic Obstructive</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Smoking</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Administration, Inhalation</term><term>Aged</term><term>Aged, 80 and over</term><term>Community Pharmacy Services</term><term>Cross-Sectional Studies</term><term>Female</term><term>Humans</term><term>Male</term><term>Medication Adherence</term><term>Medication Errors</term><term>Metered Dose Inhalers</term><term>Middle Aged</term><term>Primary Health Care</term><term>Retrospective Studies</term><term>Surveys and Questionnaires</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>Chronic obstructive pulmonary disease (COPD) is a prevalent disease that is frequently treated in primary care. However, data regarding the primary care management of COPD are scarce. Such observational data are necessary to detect problem areas and to develop targeted interventions for improvement of COPD management.</p></div><div type="abstract" xml:lang="en"><p><b>OBJECTIVE</b></p><p>To provide a detailed description of (1) drug therapy, (2) drug adherence, (3) inhalation technique, and (4) health status of patients with COPD recruited via community pharmacies.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>A cross-sectional, observational study was conducted in 93 pharmacies in Belgium. Participants (N = 555) completed a questionnaire collecting information on personal characteristics, smoking history, influenza vaccination, COPD medication, and adverse effects. Adherence to COPD maintenance medication was analyzed 1 year retrospectively through prescription refill rates. Inhalation technique was scored using a checklist. Health status was evaluated with the St. George's Respiratory Questionnaire, the Clinical COPD Questionnaire, and the Modified Medical Research Council dyspnea scale.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>The mean age of the patients was 68.6 years; 73.7% were men and 37.2% were current smokers. The influenza vaccination status was significantly lower in patients aged less than 65 years (65.7%) than in patients aged 65 years or more (86.2%) (p < 0.001). Fixed combinations of inhaled corticosteroids and long-acting beta(2)-agonists were the most frequently used COPD medications (75.4%). About 48% of patients were underadherent (<80% adherence), 47% were adherent (80-120% adherence) and 5% were overadherent (>120% adherence). Predictors for underadherence were age and number of drugs. Twenty-one percent of patients made major inhalation technique errors with rescue medication; these were all errors in handling pressurized metered-dose inhalers (pMDIs).</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>This observational study on COPD management in primary care highlights 4 main aspects that could be improved: (1) drug adherence, (2) inhalation technique with pMDIs, (3) influenza vaccination in COPD patients younger than 65 years, and (4) smoking cessation.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">20103611</PMID><DateCompleted><Year>2010</Year><Month>04</Month><Day>26</Day></DateCompleted><DateRevised><Year>2015</Year><Month>11</Month><Day>19</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1542-6270</ISSN><JournalIssue CitedMedium="Internet"><Volume>44</Volume><Issue>2</Issue><PubDate><Year>2010</Year><Month>Feb</Month></PubDate></JournalIssue><Title>The Annals of pharmacotherapy</Title><ISOAbbreviation>Ann Pharmacother</ISOAbbreviation></Journal><ArticleTitle>COPD management in primary care: an observational, community pharmacy-based study.</ArticleTitle><Pagination><MedlinePgn>257-66</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1345/aph.1M481</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Chronic obstructive pulmonary disease (COPD) is a prevalent disease that is frequently treated in primary care. However, data regarding the primary care management of COPD are scarce. Such observational data are necessary to detect problem areas and to develop targeted interventions for improvement of COPD management.</AbstractText><AbstractText Label="OBJECTIVE" NlmCategory="OBJECTIVE">To provide a detailed description of (1) drug therapy, (2) drug adherence, (3) inhalation technique, and (4) health status of patients with COPD recruited via community pharmacies.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">A cross-sectional, observational study was conducted in 93 pharmacies in Belgium. Participants (N = 555) completed a questionnaire collecting information on personal characteristics, smoking history, influenza vaccination, COPD medication, and adverse effects. Adherence to COPD maintenance medication was analyzed 1 year retrospectively through prescription refill rates. Inhalation technique was scored using a checklist. Health status was evaluated with the St. George's Respiratory Questionnaire, the Clinical COPD Questionnaire, and the Modified Medical Research Council dyspnea scale.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">The mean age of the patients was 68.6 years; 73.7% were men and 37.2% were current smokers. The influenza vaccination status was significantly lower in patients aged less than 65 years (65.7%) than in patients aged 65 years or more (86.2%) (p < 0.001). Fixed combinations of inhaled corticosteroids and long-acting beta(2)-agonists were the most frequently used COPD medications (75.4%). About 48% of patients were underadherent (<80% adherence), 47% were adherent (80-120% adherence) and 5% were overadherent (>120% adherence). Predictors for underadherence were age and number of drugs. Twenty-one percent of patients made major inhalation technique errors with rescue medication; these were all errors in handling pressurized metered-dose inhalers (pMDIs).</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">This observational study on COPD management in primary care highlights 4 main aspects that could be improved: (1) drug adherence, (2) inhalation technique with pMDIs, (3) influenza vaccination in COPD patients younger than 65 years, and (4) smoking cessation.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Mehuys</LastName><ForeName>Els</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium. els.mehuys@ugent.be</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Boussery</LastName><ForeName>Koen</ForeName><Initials>K</Initials></Author><Author ValidYN="Y"><LastName>Adriaens</LastName><ForeName>Els</ForeName><Initials>E</Initials></Author><Author ValidYN="Y"><LastName>Van Bortel</LastName><ForeName>Luc</ForeName><Initials>L</Initials></Author><Author ValidYN="Y"><LastName>De Bolle</LastName><ForeName>Leen</ForeName><Initials>L</Initials></Author><Author ValidYN="Y"><LastName>Van Tongelen</LastName><ForeName>Inge</ForeName><Initials>I</Initials></Author><Author ValidYN="Y"><LastName>Remon</LastName><ForeName>Jean-Paul</ForeName><Initials>JP</Initials></Author><Author ValidYN="Y"><LastName>Brusselle</LastName><ForeName>Guy</ForeName><Initials>G</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2010</Year><Month>01</Month><Day>26</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Ann Pharmacother</MedlineTA><NlmUniqueID>9203131</NlmUniqueID><ISSNLinking>1060-0280</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D000336">Aerosols</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D007252">Influenza Vaccines</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D004364">Pharmaceutical Preparations</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000280" MajorTopicYN="N">Administration, Inhalation</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000336" MajorTopicYN="N">Aerosols</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000369" MajorTopicYN="N">Aged, 80 and over</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D001530" MajorTopicYN="N" Type="Geographic">Belgium</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D003157" MajorTopicYN="N">Community Pharmacy Services</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D003430" MajorTopicYN="N">Cross-Sectional Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007252" MajorTopicYN="N">Influenza Vaccines</DescriptorName><QualifierName UI="Q000008" MajorTopicYN="N">administration & dosage</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D055118" MajorTopicYN="Y">Medication Adherence</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008508" MajorTopicYN="N">Medication Errors</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D036501" MajorTopicYN="N">Metered Dose Inhalers</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D004364" MajorTopicYN="N">Pharmaceutical Preparations</DescriptorName><QualifierName UI="Q000008" MajorTopicYN="Y">administration & dosage</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011320" MajorTopicYN="N">Primary Health Care</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D029424" MajorTopicYN="N">Pulmonary Disease, Chronic Obstructive</DescriptorName><QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012189" MajorTopicYN="N">Retrospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012907" MajorTopicYN="N">Smoking</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011795" MajorTopicYN="N">Surveys and Questionnaires</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2010</Year><Month>1</Month><Day>28</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2010</Year><Month>1</Month><Day>28</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2010</Year><Month>4</Month><Day>27</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">20103611</ArticleId><ArticleId IdType="pii">aph.1M481</ArticleId><ArticleId IdType="doi">10.1345/aph.1M481</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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