COPD Patient Support is Cost Effective, Improves Adherence

Community pharmacists’ support of chronic obstructive pulmonary disease (COPD) patients is cost effective and can improve adherence, according to research published in the International Journal of Pharmacy Practice.

Researchers from the United Kingdom observed 238 patients in 21 pharmacies in 1 geographical area of the UK who were recruited over a 10 week period in order to evaluate the effect of a community pharmacy based COPD service on patient outcomes. The researchers noted the UK government would like to see community pharmacists involved in COPD and other chronic disease management, and believe COPD would be a good starting point to evaluate a management program’s effectiveness.

There were 306 patients involved in the service, which consisted of posted signs about advertising smoking cessation services, therapy optimization, and recommendation to obtain a rescue pack which contained steroid and antibiotic to prevent hospitalization as a result of chest infection. The patients were observed over a 6 month period. Data was collected about clinical outcomes, patient self reported medication adherence, quality of life, and National Health Service (NHS) resource utilization.

The services implemented by community pharmacists improved patient medication adherence and was cost effective, the researchers found. Moreover, more than half of patients screened by pharmacies were identified as being at a higher risk of COPD. The researchers estimate that £264 million (410,365,560 USD) in lost productivity costs could be saved by diagnosing patients with COPD earlier. A secondary assessment showed that lifetime savings from smoking cessation would be an estimated £215 million (334,199,225 USD).

In the group, there were 88 smokers identified, 39 percent of which declined cessation aid services, 18 percent utilized pharmacy based services, and 34 percent were referred to other cessation support. An additional 63 percent of the screened patients were offered lifestyle advice: 41 percent about smoking, 13 percent about diet and nutrition, 21 percent about physical activity, 7 percent on alcohol consumption, 5 percent on weight management, and 8 percent on other topics.

“Our evidence from this service evaluation shows that case finding of COPD patients by community pharmacy is possible. Targeted screening identifies one patient with moderately severe COPD risk for every two who are screened,” lead researcher David Wright, BPharm, PhD, explained in a press release. “A simple cost analysis based on the smoking cessation element alone suggests that providing the cost per patient screened is less than £400 (620 USD), then the service should be adopted by the NHS because the costs are less than the current model of doing nothing.”