Pharmacists Reduce Hospital Visits For Respiratory Patients

Main Category: Pharmacy / Pharmacist
Also Included In: COPD
Article Date: 09 Sep 2008 - 2:00 PDT

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Patients with chronic obstructive pulmonary disease (COPD) experience 55% fewer hospital admissions and 50% less visits to accident and emergency departments when clinical pharmacists intervene in their care, research launched at the British Pharmaceutical Conference (BPC) in Manchester has shown.

Six months into a year-long study on a pharmacy-led disease and medicine management programme in patients with COPD (an umbrella term for serious respiratory diseases like emphysema), pharmacy researchers in Belfast have shown that the involvement of a clinical pharmacist improves patients' health-related quality of life and results in greater cost-effectiveness for the NHS.

Patients in the study group reported 81% adherence to medication regimes, compared to only 60% in the control group.

The study maintained a strong focus on self-management because COPD patients may benefit from the early intervention that comes from following self-management plans(1),(2), which may prevent a crisis and possibly the need for hospital admission.

Lead researcher, Maher Al-khdour, said: "This ongoing study indicates that a management programme led by clinical pharmacists can improve adherence, reduce the need for hospital care in patients with moderate to severe COPD and improve their quality of life."

Through a separate study investigating inhaler treatments for patients with asthma and COPD, John Moores University pharmacy researchers in Liverpool found that switching inhaler medicines could result in NHS savings of £5,100 a year. Two similar and equally effective inhalers are available - the newer Symbicort inhaler is not as well-known or prescribed as often as the Seratide inhaler, but is much cheaper.

Head researcher, Lewis Brien, said: "This study indicates considerable progress in the management of these chronic respiratory diseases. It also highlights the fact that more detailed clinical interventions can result in both health and cost benefits - a demonstration of the value and expertise of pharmacists."

About Chronic Obstructive Pulmonary Disease (COPD)

COPD is an umbrella term covering a range of conditions including chronic bronchitis and emphysema. It is a long term condition that leads to damaged airways, causing them to become narrow, making it harder for air to get in and out of the lungs. There is no cure for COPD, but it can be managed through drug therapy.

The World Health Organisation estimates suggest that COPD will become the third leading cause of death, world-wide, by 2030: http://www.who.int/gard/news_events/World_Health_Statistics_2008/en/

About Asthma

Asthma affects the airways of the lungs ( http://www.nhsdirect.nhs.uk/glossary/#Lung ) (the bronchi) which causes the airways to become inflamed and swollen. The bronchi are small tubes that carry air in and out of the lungs. In asthmatics, bronchi are more sensitive than normal and certain substances, or triggers, can irritate them.

Common triggers include house dust mites, animal fur, pollen, tobacco smoke, cold air, and chest infections. When the bronchi are irritated, they become narrow and the muscles around them tighten, which can increase the production of sticky mucus, or phlegm. This makes it difficult to breathe, and causes wheezing (http://www.nhsdirect.nhs.uk/glossary/#Wheezing), coughing, and a feeling of tightness in the chest.

The United Kingdom has one of the highest incidences of asthma in the world(3). Over 5 million people suffer from the condition(4), which causes around 2000 deaths annually; approximately 90% of which are avoidable(3).

Despite better health care and medical advances, asthma is the only disease in the UK still increasing in prevalence. In England, the mortality rate from respiratory diseases is almost double the average for Europe(5).

About the British Pharmaceutical Conference 2008 (BPC)

BPC 2008: Pharmacy in the 21st Century: Adding years to life and life to years. In 2008, as the NHS marks its 60th anniversary year, BPC will examine how pharmacy and the pharmaceutical services are helping to add years to life and life to the year of the UK population. The profession of pharmacy plays an important role in meeting the healthcare challenges associated with the UK's ageing population.

How can pharmacists contribute to caring for the population as well as ensuring quality of life? Increasingly, scientists and practitioners have to consider the cost implications of this conundrum, and the evidence base for all interventions is becoming of paramount importance: BPC 2008 will debate these issues and open up discussion on them.

http://www.bpc2008.org

The main sponsors of BPC 2008 are: Boots The Chemists (Lead Sponsor), AstraZeneca (Associate Sponsor and BPC-PJ Careers Forum Platinum Sponsor), Pharmacists' Defence Association (PDA) (Associate Sponsor) and GSK (BPC-PJ Careers Forum Platinum Sponsor).

Research released at BPC is published in the International Journal of Pharmacy Practice (IJPP).

References

(1) Bourbeau J, et al. Reduction of hospital utilization in patients with chronic obstructive pulmonary disease: a disease specific self-management intervention. Arch Intern. Med. 2003; 163, 585 -591.

(2) Lorig KR, et al. Evidence suggesting that a chronic disease self-management program can improve health status while reducing hospitalization: a randomized trial. Medical care. 1999; 37, 5-14.

(3) Asthma UK. "Where do we stand? Asthma in the UK today" December 2004. p3 - 10.

(4) Prescribing Review. Drugs used in asthma and COPD. Prescription Pricing Division. May 2007.

(5) It takes your breath away: The Impact of Chronic Obstructive Pulmonary Disease. CMO Annual Report 2004. Pages 21 and 23.

British Pharmaceutical Conference