Hospital-Based Clinical Pharmacy Services to Improve Ambulatory Management of Chronic Obstructive Pulmonary Disease

Smith, Amber; Palmer, Valerie S.; Farhat, Nada; Kalus, James S.; DiGiovine, Bruno; MacDonald, Nancy

doi:10.1177/8755122516675635

Cited by 11 publications

(10 citation statements)

References 23 publications

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“…Although the costs associated with non-compliance was significantly higher, several reasons were cited for COPD patients choosing to be non-compliant with treatment. The patient's understanding of the treatment plan, misuse (overuse, underuse, or improperly used) of therapy medications decreases the ability to determine the effectiveness of therapy and the patient's inability to inhale medication for optimal medication deposition in the lungs (Smith et al, 2017). There are two different behaviors of patients that contribute to non-compliance intentional and unintentional.…”

Section: Resultsmentioning

confidence: 99%

The Cost of Chronic Obstructive Pulmonary Disease (COPD) in Compliant Versus Non-Compliant Patients

Rudd

Jackman

2021

J Stud Res

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A literature review conducted, on the cost of Chronic Obstructive Pulmonary Disease (COPD) between patients who are compliant versus non-compliant, reflects on the data for the United States with an emphasis on the areas within the Florida Panhandle. An overview of costs associated with noncompliant COPD patients and strategies for encouraging patients to adhere to treatment and improve healthcare outcomes is provided. A review of recent peer-reviewed articles was performed to determine the additional costs associated with non-compliance. The direct cost of COPD was estimated at $6,246 per patient annually. Nationally projected expenditures for COPD were $49.9 billion in 2010, while costs in Florida were $2.5 billion. Florida’s costs for COPD management ranks much higher than the national average. Potential causes for the differentiation are associated with newer medications and devices that contribute to a higher out-of-pocket expense for patients, patient denial about the seriousness of their illness, and/or inability to understand compliance with treatment. The relationship between the primary care provider and COPD patient is critical for adherence to therapy.

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Section: Resultsmentioning

confidence: 99%

The Cost of Chronic Obstructive Pulmonary Disease (COPD) in Compliant Versus Non-Compliant Patients

Rudd

Jackman

2021

J Stud Res

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“…Thirty‐four studies evaluated disease state management programs . Among these, the most common conditions addressed were: diabetes (35%), infectious diseases (eg, human immunodeficiency virus, hepatitis C) (15%), cardiovascular disease (15%), transplant (9%), psychiatric disorders (9%), and chronic obstructive pulmonary disease (6%) (Table S2).…”

Section: Resultsmentioning

confidence: 99%

Economic evaluations of clinical pharmacy services in the United States: 2011‐2017

Talon

Pérez

Yan

et al. 2019

J Am Coll Clin Pharm

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Studies evaluating the cost-effectiveness of clinical pharmacy services (CPS) are needed to justify implementation and reimbursement. Through a systematic review, we describe services provided by pharmacists and their economic outcomes. We conducted a literature search of published studies in PubMed, Ovid, and Embase from January 2011 through December 2017. Manuscripts evaluating a CPS with patient-level economic outcomes and conducted in the United States were included. Study risks of bias were classified by study design characteristics. Economic evaluations were classified according to the presence of a comparator, and cost and outcome measures included. The quality of full economic evaluations was assessed using the Quality of Health Economic Studies (QHES) instrument. Descriptive statistics were used to summarize CPS characteristics. After screening, 115 studies wereincluded. Type of service provided included general pharmacotherapy (41%), disease management (30%), and targeted drug program (17%). Settings included hospital (34%), ambulatory care (28%), and community pharmacy (17%). Study designs were considered high risk of bias (use of a historical control group or no control group) in 69% of cases while 25% were medium risk of bias (non-randomized with a concurrent control group) and 6% were low risk of bias (randomized experimental or multigroup interrupted time series). Economic evaluation types were descriptive studies that measured cost and/or outcomes of a CPS (55%), comparative studies that measured cost or outcomes of a CPS and a comparator (37%), and full evaluations that measured cost and outcomes of a CPS and a comparator (8%). Among nine full evaluations, the median (range) QHES score was 74 (59-95) and four reported the CPS as being more effective at a lower cost. Few full economic evaluations were conducted, but supported the cost-effectiveness of CPS. Use of a comparator group and measurement of economic inputs and outcomes would strengthen the body of evidence. K E Y W O R D Scost-benefit analysis, health services research, pharmacoeconomics, pharmacy

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“… 35 A pharmacist-led bundle improved outpatient management of COPD and decreased phone calls. 36 A study showed that pharmacist-led training improved inhaler techniques and shortened the training time. 37 Hence, pharmacists can play multiple important roles in the CP of AECOPD.…”

Section: Discussionmentioning

confidence: 99%

The Role of the Clinical Pharmacist on the Health Outcomes of Acute Exacerbations of Chronic Obstructive Pulmonary Disease (AECOPD)

Gong¹,

Chen²,

Zhang³

2022

COPD

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Background Clinical pharmacists play a significant role in clinical practice, but their work in the clinical pathway (CP) of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) remains undefined. Methods This prospective study included patients who met the discharge criteria during hospitalization at the department of respiratory medicine of the Second Affiliated Hospital of Fujian Medical University from March to December 2017 (no pharmacists involved) and from March 2018 to January 2019 (pharmacists involved). The adverse drug reaction (ADR) reporting rate, the average DDD number of antibacterial drugs, the per capita cost of pharmaceutical services, and the benefit-cost ratio (B/C) were analyzed. Results and Discussion Eighty participants were enrolled during the traditional period and eighty-five participants during the clinical pharmacist period. The average hospital stays (9.2±0.4 vs 10.7±0.6 days, P=0.032), the total cost of hospitalization expenses (¥ 14,058±826 vs ¥ 18,765±1434, P=0.004), the total cost of drugs (¥ 5717±449 vs ¥ 8002±755, P=0.004), and cost of antimicrobial drugs (¥ 3639±379 vs ¥ 5636±641, P=0.007) were all lower in the clinical pharmacist group than in the traditional group. The B/C was 10.38 and 5.05 in the total cost of hospitalization expenses and the total cost of drugs, respectively. The clinical pharmacists’ participation was independently associated with the total cost of hospitalization expenses (β=−0.201, 95% confidence interval: −0.390, −0.055, P=0.010). What is New and Conclusion The participation of the clinical pharmacist in implementing an AECOPD CP significantly reduces patients’ hospitalization days, the total cost of hospitalization expenses, and antibiotic use and improves the B/C of AECOPD management. The clinical pharmacists’ participation was independently associated with the total hospitalization expenses.

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Hospital-Based Clinical Pharmacy Services to Improve Ambulatory Management of Chronic Obstructive Pulmonary Disease

Cited by 11 publications

References 23 publications

The Cost of Chronic Obstructive Pulmonary Disease (COPD) in Compliant Versus Non-Compliant Patients

The Cost of Chronic Obstructive Pulmonary Disease (COPD) in Compliant Versus Non-Compliant Patients

Economic evaluations of clinical pharmacy services in the United States: 2011‐2017

The Role of the Clinical Pharmacist on the Health Outcomes of Acute Exacerbations of Chronic Obstructive Pulmonary Disease (AECOPD)

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