Impact of clinical pharmacist intervention in chronic obstructive pulmonary disease management

Jackin R. Moses, Neena Priyamalar E. M., Shilpa Ravi, Raveena Pachal Balakrishnan, Rajganesh Ravichandran, Lavanya Selvaraj


Background: Chronic obstructive pulmonary disease (COPD) is a common, preventable, and treatable disease characterized by persistent respiratory symptoms and airflow limitation. In 2016, COPD is the third leading cause of death globally and is projected to increase by more than 30% in the next 10 years. The main threat to the prognosis lies in the lack of disease knowledge, poor medication adherence, and health-related quality of life. Clinical Pharmacist is a key profession to improve patient care in COPD management and literature in this regard is very limited. It is important to establish the impact of a clinical pharmacist as an indicator to improve patient outcomes. Hence the aim of this was to assess the Impact of Clinical Pharmacist Intervention in COPD management in a Tertiary care hospital.

Methods: The study was conducted as a prospective and interventional. A total of 53 patients were recruited in the study. The study participants were educated by a clinical pharmacist on disease state, medications, and breathing techniques. Patients have a regular follow-up after 6 months during a scheduled visit. Questionnaires were administered to all patients at baseline and 6 months to assess their medication adherence, disease-related knowledge, and HRQoL.

Results: Out of 53 study participants, the majority of COPD patients 23 (46.94%) were found to be in the elderly age group of 60-69 years. The majority of the patients were in a severe category of 48.98%. Thereafter intervention assessment of COPD related knowledge showed a 33.45% improvement. The majority of study participants showed high adherence after the intervention of 46.94 %. All aspects of the HRQoL questionnaire showed improvement after intervention. The results were statistically significant.  

Conclusions: The Pharmacist-led COPD Intervention showed improvement in the three main aspects of the study. It confirms the need for healthcare systems to recognize the role of clinical pharmacists in both pharmacological therapy and non-pharmacological supportive care.


Clinical pharmacist intervention, Patient education, Health related quality of life, Medication adherence

Full Text:



Mohan H, Mohan P, Mohan T, Mohan S- Textbook of Pathology -7th edition, Jaypee Brothers Medical Publishers (P)Ltd. 2015;468-70

Epidemiology. WHO burden of COPD–WHO. Available at:>respiratory> burden. Accessed on 25 June 2019.

Goldcopdorg. Global Initiative for Chronic Obstructive Lung Disease- GOLD. Available at: Accessed on 25 June 2019.

Khdour MR, Kidney JC, Smyth BM, McElnay JC. Clinical pharmacy‐led disease and medicine management programme for patients with COPD. Br J Clin pharmacol. 2009;68(4):588-98

Engström CP, Persson LO, Larsson S, Sullivan M. Health-related quality of life in COPD: why both disease-specific and generic measures should be used. Europe Respirat J. 2001;18(1):69-76.

Sarkar SK, Basuthakur S, Das SK, Das A, Das S, Choudhury S, et al. Evaluation of correlation of BODE index with health-related quality of life among patients with stable COPD attending a tertiary care hospital. Lun Ind. 2015;32(1):24.

Zamzam MA, Azab NY, El Wahsh RA, Ragab AZ, Allam EM. Quality of life in COPD patients. Egypt J Chest Dis Tuberc. 2012;61(4):281-9.

Koff PB, Jones RH, Cashman JM, Voelkel NF, Vandivier RW. Proactive integrated care improves quality of life in patients with COPD. Europe Respirat J. 2009;33(5):1031-8

Siva KK, Gayathri AR. Prevalence of comorbid conditions in patients of chronic obstructive pulmonary disease (COPD) with acute exacerbation. Int J Sci Resear. 2015;4(2):1847-50.

Restrepo RD, Alvarez MT, Wittnebel LD, Sorenson H, Wettstein R, Vines DL, et al. Medication adherence issues in patients treated for COPD. Int J Chron Obstruct Dis. 2008;3(3):371.

Mohsen S, Hanafy FZ, Fathy AA, El-Gilany AH. Non-adherence to treatment and quality of life among patients with chronic obstructive pulmonary disease. Lun Ind .2019;36(3):193.

Ahmed MS, Neyaz A, Aslami AN. Health-related quality of life of chronic obstructive pulmonary disease patients: Results from a community based cross-sectional study in Aligarh, Uttar Pradesh, India. Lun Ind: 2016;33(2):148

Hersh CP, Hokanson JE, Lynch DA, Washko GR, Make BJ, Crapo JD, et al. COPD Gene Investigators. Family history is a risk factor for COPD Ches. 2011;140(2):343-50.

Smith AL, Palmer V, Farhat N, Kalus JS, Thavarajah K, DiGiovine B, et al. Hospital-based clinical pharmacy services to improve ambulatory management of chronic obstructive pulmonary disease. Resear J Pharma Technol. 2017;33(1):8-14.

Ahmed MS, Neyaz A, Aslami AN. Health-related quality of life of chronic obstructive pulmonary disease patients: Results from a community based cross-sectional study in Aligarh, Uttar Pradesh, India. Lun Ind. 2016;33(2):148.

Saleem M, Priya S, Pradeep M, Sabeetha K. A study on the prevalence of chronic obstructive pulmonary disease among adults in Madurai, Tamil Nadu. Int J Commun Medic Pub Heal. 2017;4(11):4113-9.

Anzueto A, Leimer I, Kesten S. Impact of frequency of COPD exacerbations on pulmonary function, health status and clinical outcomes. In J Chronic Obstruct Pulmon Dis. 2009;4:245.

Ding H, Karunanithi M, Kanagasingam Y, Vignarajan J, Moodley Y. A pilot study of a mobile-phone-based home monitoring system to assist in remote interventions in cases of acute exacerbation of COPD. J Telemed Telecare. 2014;20(3):128-34.

Wacker ME, Jörres RA, Karch A, Wilke S, Heinrich J, Karrasch S, Koch A, Schulz H, Watz H, Leidl R, Vogelmeier C. Assessing health-related quality of life in COPD: comparing generic and disease-specific instruments with focus on comorbidities. Brit Med Cent. 2016;16(1):70.

Khajamohinuddin S et al. Effect of Pulmonary Rehabilitation in Chronic Obstructive Pulmonary Disease Patients to Improve Quality of Life. Int J Physiother Res. 2014;2(5):689-4.

Marin JM, Cote CG, Diaz O, Lisboa C, Casanova C, Lopez MV, Carrizo SJ, Pinto-Plata V, Dordelly LJ, Nekach H, Celli BR. Prognostic assessment in COPD: health-related quality of life and the BODE index. Respir Med. 2011;105(6):916-21.