The impact of pharmacist-managed clinic on medication adherence and health-related quality of life in patients with COPD: a randomized controlled study

Figures & data

Figure 1 Flow of participants through the study.

Table 1 Patient demographics and clinical characteristics at baseline

Demographic	PMC group (n=114)	Control group (n=113)	P-value
Age, mean ± SD (range) (years)	64.2±14.2	64.6±14.5	0.178
Sex, n (%)			0.043
Male	44 (38.6)	42 (37.1)
Female	70 (61.4)	71 (62.8)
Mean body mass index (SD) (kg/m^2)	27.9±1.5	28.1±1.8	0.637
Current smokers, n (%)	85 (74.5)	84 (74.3)	0.949
Education, n (%)			0.825
High (university)	35 (30.7)	32 (28.3)
Low	79 (69.3)	81 (71.6)
Marital status, n (%)			0.924
Married	112 (98.2)	112 (99.1)
Other	2 (1.7)	1 (0.8)
Living arrangements, n (%)			0.982
Alone	22 (19.3)	22 (19.4)
Not alone	92 (80.7)	91 (80.5)
FEV1, mean ± SD			0.815
% predicted	55.4±15.7	54.7±14.9
FEV1/FVC	51.5±9.2	50.8±8.8
Duration of COPD, mean ± SD (years)	11.5±9.3	10.8±9.1	0.842
Number of COPD medications, mean ± SD	6.4±1.0	6.2±1.0	0.904
Number of hospital admissions (last 12 months)	73	71	0.957
Comorbid conditions, n (%)	84 (73.6)	85 (75.2)	0.822

Abbreviations: PMC, pharmacist-managed clinic; SD, standard deviation; FEV₁, forced expiratory volume in 1 second; FVC, forced vital capacity.

Table 2 Prescribed medications for COPD in the PMC and control group patients

Prescribed medication	Baseline		12-month treatment
	PMC group, n (%)	Control group, n (%)	PMC group, n (%)	Control group, n (%)
SABA	55 (45.0)	54 (44.2)	51 (44.7)	49 (43.3)
LABA/ICS	58 (47.5)	50 (40.9)	68 (59.6)	64 (56.6)
LABA	14 (11.4)	15 (12.3)	17 (14.9)	16 (14.2)
LAMA	63 (51.6)	62 (50.8)	84 (73.6)	81 (71.6)
Oral steroids	7 (5.7)	9 (7.4)	8 (7.0)	5 (4.4)
Anticholinergic agents	32 (26.2)	35 (28.6)	37 (32.4)	38 (33.6)
Xanthines	22 (18.0)	25 (20.4)	24 (21.0)	25 (19.4)
P-value	0.74		0.63

Abbreviations: PMC, pharmacist-managed clinic; SABA, short-acting β₂ agonist; LABA, long-acting β₂ agonist; ICS, inhaled corticosteroid; LAMA, long-acting muscarinic antagonist.

Table 3 Medication adherence in the PMC and control group over the 12-month assessment period

Adherence to maintenance medication	PMC group	Control group	P-value
MRA score, mean ± SD
Baseline	78.8±12.3	77.4±12.2	0.798
12-month intervention	93.1±14.2	83.2±12.7	0.003
No of patients with MRA ≥80, n (%)
Baseline	63	61	0.904
12-month intervention	95 (83.3%)	58 (51.3%)	0.002

Abbreviations: PMC, pharmacist-managed clinic; MRA, medication refill adherence; SD, standard deviation.

Table 4 Changes in SGRQ scores at different time assessments

SGRQ scores	PMC group, mean ± SD	Control group, mean ± SD	P-value
Total score
Baseline	50.9±4.7	50.6±4.6	0.949
After 6 months of treatment	47.2±4.6	49.2±4.4	0.618
After 12 months of treatment	42.7±3.2	52.4±5.2	0.024
Symptoms
Baseline	47.9±4.4	47.4±4.2	0.924
After 6 months of treatment	40.2±2.7	46.8±4.5	0.227
After 12 months of treatment	38.2±2.2	44.2±3.8	0.028
Activities
Baseline	53.2±4.9	54.6±4.6	0.835
After 6 months of treatment	47.6±3.2	56.6±4.7	0.427
After 12 months of treatment	42.3±2.5	50.2±2.7	0.025
Impacts
Baseline	43.2±5.4	44.6±5.1	0.822
After 6 months of treatment	35.7±2.9	45.8±5.5	0.424
After 12 months of treatment	30.8±2.4	42.8±2.3	0.024

Abbreviations: SGRQ, St George’s Respiratory Questionnaire; PMC, pharmacist-managed clinic; SD, standard deviation.

Table 5 Severe exacerbations, hospitalizations, and smoking status over the 12 months

Severe exacerbations, hospitalizations, and smoking status	PMC group, n=114	Control group, n=113	P-value
Severe exacerbations
Patients with event, n (%)	14 (12.2)	28 (24.7)	0.024
Total events (n)	16	35
Hospitalizations
Patients with event, n (%)	9 (7.8)	24 (21.2)	0.015
Total hospitalizations (n)	11	35
Duration of hospitalization, mean ± SD (days)	8.1±2.2	14.2±2.8	0.042
Current smokers
After 12 months, n (%)	4 (3.5)	25 (22.1)	0.022
Quit smoking, n (%)	81 (71.0)	59 (52.2)

Note: Exacerbations requiring an emergency department visit or hospitalization were regarded as severe.

Abbreviations: PMC, pharmacist-managed clinic; SD, standard deviation.