Chronic obstructive pulmonary disease (COPD) is an irreversible chronic respiratory disease whose evolution depends on the patient’s adherence to inhaler devices. Pharmacists may play a role in adherence to medication therapy in hospital and in primary care interacting with patients to provide advice on proper use. This paper presents the protocol for a randomized controlled trial conducted at a university hospital to assess the clinical impact of pharmaceutical consultations on COPD exacerbations, medical care, adherence to inhaler devices and quality of life.
This trial will include 226 COPD patients treated with inhaler devices: 94 in a control group with the usual hospital care, 66 receiving a pharmaceutical consultation at the hospital and 66 receiving several pharmaceutical consultations at their community pharmacy. The aim of these interventions is to inform patients about COPD and medication therapy, train them in the proper use of inhaler devices and make them aware of good therapeutic adherence. Patients will be randomized to either the control group or the experimental hospital group by the clinical pharmacist at the hospital. Community pharmacists will include patients in the experimental community group. All patients will be monitored for 12 months by their community pharmacists (CPs). The primary outcome is the mean number of COPD exacerbations. Secondary outcomes include the number of medical consultations, emergency visits and hospitalizations; patients’ adherence to inhaler devices and ability to use them and quality of life.
Our study is the first randomized controlled trial in France to assess the effect of pharmaceutical interventions on COPD exacerbations. Study limitations include patient recruitment and the CPs’ adherence to follow-up. Indeed, the success of this trial depends on the willingness of CPs to collect the data. However, we envisage this work as the first step towards building a network of CPs trained for clinical research.
Clinicaltrials.gov, NCT03704545. Registered on October 12th, 2018. https://clinicaltrials.gov/ct2/show/NCT03704545?cond=COPD&cntry=FR&city=nimes&draw=2&rank=1