Abstract
Background
Patients with COPD should engage in self-management strategies targeting behavioural traits and lifestyle risk factors for optimal outcomes.
Aim
To evaluate the impact of credentialed pharmacist-led home medicines review (HMR) targeting treatable traits (TTs) on health outcomes in COPD in primary care.
Methods
A pre- and post-intervention study was nested within a cluster-randomised controlled trial. A total of 81 participants with COPD from 21 Australian general practices received an HMR with a credentialed pharmacist targeting TTs. Changes in health outcomes at 6 and 12 months from baseline were assessed.
Results
Ten TTs were assessed and targeted during the HMR. At baseline, no-one had a written action plan for managing exacerbations, and medication adherence was sub-optimal in 85% of patients. In addition, 53% of participants demonstrated inadequate inhaler device technique, while 52% were current smokers. At 6-months follow-up, significant improvements were observed in HRQoL (mean SGRQ score = 34.6 versus 39.1 at baseline, p = 0.006), health status (median CAT score = 12 versus 16, p = 0.002), anxiety (median HADS-A score = 2.5 versus 5.0, p < 0.001), depression (median HADS-D score = 1.0 versus 5.0, p < 0.001), self-reported smoking (current smokers 47% versus 51.9%, p = 0.031) and adherence to treatment (median TABS score = 12.5 versus 9.0, p = 0.002). At 12-months: health status, anxiety, depression, smoking abstinence and adherence to treatment, continued to show statistically significant improvements compared to baseline measurements.
Conclusion
HMRs targeting TTs improved health outcomes in people with COPD. Credentialed pharmacists in primary care can work alongside GPs to optimise management of COPD.