COPD management in primary care: an observational, community pharmacy-based study.
Identifieur interne : 000077 ( Main/Curation ); précédent : 000076; suivant : 000078COPD management in primary care: an observational, community pharmacy-based study.
Auteurs : Els Mehuys [Belgique] ; 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.
Descripteurs français
- KwdFr :
- Administration par inhalation, Adulte d'âge moyen, Aérosols, Aérosols-doseurs, Belgique, Broncho-pneumopathie chronique obstructive (traitement médicamenteux), Enquêtes et questionnaires, Erreurs de médication, Femelle, Humains, Mâle, Observance du traitement médicamenteux, Préparations pharmaceutiques (administration et posologie), Services des pharmacies communautaires, Soins de santé primaires, Sujet âgé, Sujet âgé de 80 ans ou plus, Tabagisme (épidémiologie), Vaccins antigrippaux (administration et posologie), Études rétrospectives, Études transversales.
- MESH :
- administration et posologie : Préparations pharmaceutiques, Vaccins antigrippaux.
- traitement médicamenteux : Broncho-pneumopathie chronique obstructive.
- épidémiologie : Tabagisme.
- Administration par inhalation, Adulte d'âge moyen, Aérosols, Aérosols-doseurs, Belgique, Enquêtes et questionnaires, Erreurs de médication, Femelle, Humains, Mâle, Observance du traitement médicamenteux, Services des pharmacies communautaires, Soins de santé primaires, Sujet âgé, Sujet âgé de 80 ans ou plus, Études rétrospectives, Études transversales.
- Wicri :
- geographic : Belgique.
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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<term>Belgium</term>
<term>Community Pharmacy Services</term>
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<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>
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<term>Surveys and Questionnaires</term>
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<keywords scheme="KwdFr" xml:lang="fr"><term>Administration par inhalation</term>
<term>Adulte d'âge moyen</term>
<term>Aérosols</term>
<term>Aérosols-doseurs</term>
<term>Belgique</term>
<term>Broncho-pneumopathie chronique obstructive (traitement médicamenteux)</term>
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<term>Sujet âgé</term>
<term>Sujet âgé de 80 ans ou plus</term>
<term>Tabagisme (épidémiologie)</term>
<term>Vaccins antigrippaux (administration et posologie)</term>
<term>Études rétrospectives</term>
<term>Études transversales</term>
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<term>Pharmaceutical Preparations</term>
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<keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Smoking</term>
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<keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Broncho-pneumopathie chronique obstructive</term>
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<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>
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<term>Adulte d'âge moyen</term>
<term>Aérosols</term>
<term>Aérosols-doseurs</term>
<term>Belgique</term>
<term>Enquêtes et questionnaires</term>
<term>Erreurs de médication</term>
<term>Femelle</term>
<term>Humains</term>
<term>Mâle</term>
<term>Observance du traitement médicamenteux</term>
<term>Services des pharmacies communautaires</term>
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<term>Études rétrospectives</term>
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<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>
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<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>
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<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>
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