Cargando…
Pharmacist involvement in the inhaler choice improves lung function in patients with COPD: a prospective single-arm study
BACKGROUND: Currently, in Japan, shifting tasks from physician to hospital pharmacist is being developed to reduce physician workload and improve the quality of pharmacotherapy. This study aimed to investigate the effects of pharmacist involvement in the choice of inhaler as the task on the clinical...
Autores principales: | , , , , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8327440/ https://www.ncbi.nlm.nih.gov/pubmed/34334137 http://dx.doi.org/10.1186/s40780-021-00211-0 |
_version_ | 1783732075803705344 |
---|---|
author | Shiwaku, Eiji Dote, Satoshi Kaneko, Shinobu Hei, Chisato Aikawa, Masaki Sakai, Yuki Kawai, Takahiro Iwatsubo, Shigeaki Hashimoto, Michinobu Tsuneishi, Teppei Nishimura, Tomoko Iwata, Toshiyuki Hira, Daiki Terada, Tomohiro Nishimura, Takashi Kobayashi, Yuka |
author_facet | Shiwaku, Eiji Dote, Satoshi Kaneko, Shinobu Hei, Chisato Aikawa, Masaki Sakai, Yuki Kawai, Takahiro Iwatsubo, Shigeaki Hashimoto, Michinobu Tsuneishi, Teppei Nishimura, Tomoko Iwata, Toshiyuki Hira, Daiki Terada, Tomohiro Nishimura, Takashi Kobayashi, Yuka |
author_sort | Shiwaku, Eiji |
collection | PubMed |
description | BACKGROUND: Currently, in Japan, shifting tasks from physician to hospital pharmacist is being developed to reduce physician workload and improve the quality of pharmacotherapy. This study aimed to investigate the effects of pharmacist involvement in the choice of inhaler as the task on the clinical outcomes of patients with chronic obstructive pulmonary disease (COPD). METHODS: This prospective, single-center, single-arm study included 36 outpatients with newly diagnosed COPD indicating inhaler therapy. Eligible patients were immediately interviewed by pharmacist. Then, pharmacist assessed patient’s inhalation flow rate, physical function to handle an inhaler, comprehension, and value, and finally recommended a personalized inhaler based on originally developed inhaler choice protocol, and pulmonologist prescribed a pharmacist-selected inhaler. The primary endpoint was the improvement in trough forced expiratory volume in 1 s (FEV(1)) between baseline and week 26. The secondary endpoints were safety, and improvements at week 26 in scores for the COPD Assessment Test (CAT), modified British Medical Research Council Dyspnea Scale (mMRC), and Adherence Starts with Knowledge-20 (ASK-20). RESULTS: The pneumonologists completely agreed with the pharmacist-recommended inhaler. Mean FEV(1) significantly increased from baseline to week 26 (1.60, SD 0.54 L vs. 1.98, SD 0.56 L; p < 0.0001). Significant improvements in CAT, mMRC, and ASK-20 scores were also observed. The prevalence of CAT responders as a negative predictor of acute exacerbation, defined as those with a decrease in CAT score of ≥2 points from baseline, was 86%. None of the patients experienced exacerbation during the study period. CONCLUSIONS: Pharmacist involvement in the choice of inhaler for patients with newly diagnosed COPD was associated with improved lung function, health status, clinical symptoms, and adherence to inhaler therapy. Shifting task of choosing appropriate inhaler from physician to hospital pharmacist may be performed effectively and safely with an inhaler choice protocol. TRIAL REGISTRATION NUMBER: UMIN000039722, retrospectively registered on March 10, 2020. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40780-021-00211-0. |
format | Online Article Text |
id | pubmed-8327440 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-83274402021-08-03 Pharmacist involvement in the inhaler choice improves lung function in patients with COPD: a prospective single-arm study Shiwaku, Eiji Dote, Satoshi Kaneko, Shinobu Hei, Chisato Aikawa, Masaki Sakai, Yuki Kawai, Takahiro Iwatsubo, Shigeaki Hashimoto, Michinobu Tsuneishi, Teppei Nishimura, Tomoko Iwata, Toshiyuki Hira, Daiki Terada, Tomohiro Nishimura, Takashi Kobayashi, Yuka J Pharm Health Care Sci Research Article BACKGROUND: Currently, in Japan, shifting tasks from physician to hospital pharmacist is being developed to reduce physician workload and improve the quality of pharmacotherapy. This study aimed to investigate the effects of pharmacist involvement in the choice of inhaler as the task on the clinical outcomes of patients with chronic obstructive pulmonary disease (COPD). METHODS: This prospective, single-center, single-arm study included 36 outpatients with newly diagnosed COPD indicating inhaler therapy. Eligible patients were immediately interviewed by pharmacist. Then, pharmacist assessed patient’s inhalation flow rate, physical function to handle an inhaler, comprehension, and value, and finally recommended a personalized inhaler based on originally developed inhaler choice protocol, and pulmonologist prescribed a pharmacist-selected inhaler. The primary endpoint was the improvement in trough forced expiratory volume in 1 s (FEV(1)) between baseline and week 26. The secondary endpoints were safety, and improvements at week 26 in scores for the COPD Assessment Test (CAT), modified British Medical Research Council Dyspnea Scale (mMRC), and Adherence Starts with Knowledge-20 (ASK-20). RESULTS: The pneumonologists completely agreed with the pharmacist-recommended inhaler. Mean FEV(1) significantly increased from baseline to week 26 (1.60, SD 0.54 L vs. 1.98, SD 0.56 L; p < 0.0001). Significant improvements in CAT, mMRC, and ASK-20 scores were also observed. The prevalence of CAT responders as a negative predictor of acute exacerbation, defined as those with a decrease in CAT score of ≥2 points from baseline, was 86%. None of the patients experienced exacerbation during the study period. CONCLUSIONS: Pharmacist involvement in the choice of inhaler for patients with newly diagnosed COPD was associated with improved lung function, health status, clinical symptoms, and adherence to inhaler therapy. Shifting task of choosing appropriate inhaler from physician to hospital pharmacist may be performed effectively and safely with an inhaler choice protocol. TRIAL REGISTRATION NUMBER: UMIN000039722, retrospectively registered on March 10, 2020. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40780-021-00211-0. BioMed Central 2021-08-02 /pmc/articles/PMC8327440/ /pubmed/34334137 http://dx.doi.org/10.1186/s40780-021-00211-0 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Article Shiwaku, Eiji Dote, Satoshi Kaneko, Shinobu Hei, Chisato Aikawa, Masaki Sakai, Yuki Kawai, Takahiro Iwatsubo, Shigeaki Hashimoto, Michinobu Tsuneishi, Teppei Nishimura, Tomoko Iwata, Toshiyuki Hira, Daiki Terada, Tomohiro Nishimura, Takashi Kobayashi, Yuka Pharmacist involvement in the inhaler choice improves lung function in patients with COPD: a prospective single-arm study |
title | Pharmacist involvement in the inhaler choice improves lung function in patients with COPD: a prospective single-arm study |
title_full | Pharmacist involvement in the inhaler choice improves lung function in patients with COPD: a prospective single-arm study |
title_fullStr | Pharmacist involvement in the inhaler choice improves lung function in patients with COPD: a prospective single-arm study |
title_full_unstemmed | Pharmacist involvement in the inhaler choice improves lung function in patients with COPD: a prospective single-arm study |
title_short | Pharmacist involvement in the inhaler choice improves lung function in patients with COPD: a prospective single-arm study |
title_sort | pharmacist involvement in the inhaler choice improves lung function in patients with copd: a prospective single-arm study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8327440/ https://www.ncbi.nlm.nih.gov/pubmed/34334137 http://dx.doi.org/10.1186/s40780-021-00211-0 |
work_keys_str_mv | AT shiwakueiji pharmacistinvolvementintheinhalerchoiceimproveslungfunctioninpatientswithcopdaprospectivesinglearmstudy AT dotesatoshi pharmacistinvolvementintheinhalerchoiceimproveslungfunctioninpatientswithcopdaprospectivesinglearmstudy AT kanekoshinobu pharmacistinvolvementintheinhalerchoiceimproveslungfunctioninpatientswithcopdaprospectivesinglearmstudy AT heichisato pharmacistinvolvementintheinhalerchoiceimproveslungfunctioninpatientswithcopdaprospectivesinglearmstudy AT aikawamasaki pharmacistinvolvementintheinhalerchoiceimproveslungfunctioninpatientswithcopdaprospectivesinglearmstudy AT sakaiyuki pharmacistinvolvementintheinhalerchoiceimproveslungfunctioninpatientswithcopdaprospectivesinglearmstudy AT kawaitakahiro pharmacistinvolvementintheinhalerchoiceimproveslungfunctioninpatientswithcopdaprospectivesinglearmstudy AT iwatsuboshigeaki pharmacistinvolvementintheinhalerchoiceimproveslungfunctioninpatientswithcopdaprospectivesinglearmstudy AT hashimotomichinobu pharmacistinvolvementintheinhalerchoiceimproveslungfunctioninpatientswithcopdaprospectivesinglearmstudy AT tsuneishiteppei pharmacistinvolvementintheinhalerchoiceimproveslungfunctioninpatientswithcopdaprospectivesinglearmstudy AT nishimuratomoko pharmacistinvolvementintheinhalerchoiceimproveslungfunctioninpatientswithcopdaprospectivesinglearmstudy AT iwatatoshiyuki pharmacistinvolvementintheinhalerchoiceimproveslungfunctioninpatientswithcopdaprospectivesinglearmstudy AT hiradaiki pharmacistinvolvementintheinhalerchoiceimproveslungfunctioninpatientswithcopdaprospectivesinglearmstudy AT teradatomohiro pharmacistinvolvementintheinhalerchoiceimproveslungfunctioninpatientswithcopdaprospectivesinglearmstudy AT nishimuratakashi pharmacistinvolvementintheinhalerchoiceimproveslungfunctioninpatientswithcopdaprospectivesinglearmstudy AT kobayashiyuka pharmacistinvolvementintheinhalerchoiceimproveslungfunctioninpatientswithcopdaprospectivesinglearmstudy |