Community pharmacists’ knowledge of COPD, and practices and perceptions of medication counseling of COPD patients

Figures & data

Table 1 Characteristics of the respondents, study pharmacies, and target population (n=263)

Variable	n (%)	Target population %a
Gender
Female	242 (92)	91.5
Male	21 (8)	8.5
Year of birth
1948–1959	26 (10)	NA
1960–1969	87 (33)	NA
1970–1979	82 (31)	NA
1980–1989	55 (21)	NA
1990–	13 (5)	NA
Education
BSc (Pharm)	220 (84)	83
MSc (Pharm)	43 (16)	17
Asthma pharmacist
Yes	196 (75)	NA
No	67 (25)	NA
Working years as a pharmacist
<10	60 (23)	NA
10–19	83 (32)	NA
20–29	84 (32)	NA
>30	36 (14)	NA
Frequency of COPD medication counseling
Less than once a week	13 (5)	NA
Once a week	29 (11)	NA
Several times a week, not daily	86 (33)	NA
Once a day	69 (26)	NA
Several times daily	66 (25)	NA
Size of the pharmacy (prescriptions per year)
<20,000	14 (5)	16.5
20,001–40,000	45 (17)	24
40,001–60,000	50 (19)	14.5
60,001–80 000	33 (13)	11
80,001–100,000	40 (15)	10.5
100,000–120,000	39 (15)	8.5
120,001–140,000	19 (7)	5.5
>140,000	23 (9)	8.5
Professional services and clinical tests provided by the pharmacy
Simple medication review	139 (53)	NA
Inhalation technique assessment service	60 (23)	NA
Comprehensive medication review (cross-professional)	52 (20)	NA
PEF measurements performed	53 (20)	NA
Microspirometries performed	44 (17)	NA
Asthma service	37 (14)	NA
Smoking cessation service	29 (11)	NA
Diabetes service	21 (8)	NA
Asthma tests performed	156 (59)	NA
COPD assessment tests performed	56 (21)	NA

Note:

a Information received from the Association of Finnish Pharmacies, May 15, 2017.

Abbreviations: NA, information not available; PEF, peak expiratory flow.

Table 2 Community pharmacists’ self-assessed level of knowledge concerning key issues of COPD and the current care guideline in Finland (n=263)

Survey statement	Number of responses and percentages to each category
According to self-assessment I know the following key issues concerning COPD:	Very well	Well	Poorly	Very poorly
Reasons	61 (23%)	178 (68%)	24 (9%)	0 (0%)
Symptoms	38 (14.5%)	200 (76%)	25 (9.5%)	0 (0%)
Inhaled medicinal products	34 (13%)	195 (74%)	33 (12.5%)	1 (0.5%)
Nonpharmacological treatments (smoking cessation, physical exercise, and nutrition)	61 (23%)	161 (61%)	41 (16%)	0 (0%)
Similarities and differences between COPD and asthma	28 (10.5%)	173 (66%)	60 (23%)	2 (1%)
Progress of the disease	26 (10%)	170 (64.5%)	66 (25%)	1 (0.5%)
Symptoms of exacerbations	21 (8%)	157 (59.5%)	83 (31.5%)	2 (1%)
Treatments of exacerbations	17 (6.5%)	141 (53.5%)	104 (39.5%)	1 (0.5%)
Non-inhaled medicinal products	13 (5%)	115 (43.5%)	125 (47.5%)	10 (4%)
Current care treatment guideline	11 (4%)	115 (44%)	134 (51%)	3 (1%)

Table 3 Self-assessment of Finnish community pharmacists (n=263) on how medication counseling of COPD patients functions in the introduction, main content, and conclusion phases of the medication counseling session, according to USP Medication Counseling Behaviour Model

Survey statement	Number of responses and percentages for each category
	Functions very well	Functions well	Functions poorly	Functions very poorly
Introduction phase
Current symptoms	13 (5%)	144 (55%)	94 (35.5%)	12 (4.5%)
Use of earlier medications	15 (5.5%)	136 (52%)	99 (37.5%)	13 (5%)
Benefits of earlier medications	14 (5.5%)	128 (48.5%)	108 (41%)	13 (5%)
Problems with earlier medications	9 (3.5%)	131 (50%)	108 (41%)	15 (5.5%)
Possible earlier exacerbations	6 (2.5%)	88 (33.5%)	146 (55.5%)	23 (8.5%)
Current smoking status	10 (4%)	51 (19%)	162 (62%)	40 (15%)
Physical status and physical habits	6 (2%)	35 (13%)	159 (61%)	63 (24%)
Nutritional status	2 (1%)	18 (7%)	156 (59%)	87 (33%)
Main content phase
How to use inhaler	73 (28%)	160 (61%)	24 (9%)	6 (2%)
Dosage, timing, maximum dosage	47 (18%)	186 (70.5%)	25 (9.5%)	5 (2%)
Guidance to seek doctor if applicable	61 (23%)	156 (59.5%)	35 (13.5%)	11 (4%)
Adverse drug reactions	20 (8%)	140 (53%)	95 (36%)	8 (3%)
Mode of action	16 (6%)	139 (53%)	90 (34%)	18 (7%)
Guidance for nonsmoking	32 (12%)	122 (46.5%)	91 (34.5%)	18 (7%)
Guidance for vaccinations	30 (11%)	97 (37%)	110 (42%)	26 (10%)
Guidance for exacerbation	9 (3.5%)	108 (41%)	130 (49.5%)	16 (6%)
Guidance for physical exercise	5 (2%)	49 (18.5%)	154 (58.5%)	55 (21%)
Guidance for nutrition	3 (1%)	24 (9%)	160 (61%)	76 (29%)
Conclusion phase
Guidance for reliable information sources	5 (2%)	46 (17.5%)	161 (61%)	51 (19.5%)

Abbreviations: COPD, chronic obstructive pulmonary disease; USP, United States Pharmacopeia.

Table 4 Perceptions of the medication counseling and the role of community pharmacists in the COPD treatment by community pharmacists in Finland (n=263)

Survey statement	Number of responses and percentages to each category
	Totally agree	Agree	Disagree	Totally disagree
Counseling work of COPD patients is meaningful	120 (46%)	116 (44%)	27 (10%)	0 (0%)
Pharmacist has an important role in the treatment chain of COPD patients	80 (30.5%)	134 (51%)	44 (16.5%)	5 (2%)
Pharmacist can motivate COPD patients for the self-management of the disease	54 (20.5%)	141 (53.5%)	64 (24.5%)	4 (1.5%)
As a pharmacist, follow-up of COPD patients is possible	49 (18.5%)	144 (55%)	61 (23%)	9 (3.5%)