Impact of a medication therapy management service on the clinical status of patients with chronic obstructive pulmonary disease.

Abstract

Background At this moment, there is no information in the literature showing the impact of comprehensive medication management (CMM) service delivered to patients with chronic obstructive pulmonary disease. Objective This study aims to present the clinical outcomes of this service provided to patients with chronic obstructive pulmonary disease. Settings Public specialty pharmacy where high cost drug treatments are provided for medical conditions not covered by the primary care such as COPD, located in Minas Gerais State, Brazil. Methods A retrospective analysis was conducted for 83 patients. The dependent variable in this study was the sum of the drug therapy problems detected during the first and second consultation. The independent variables were age, number of diseases and medications, diagnosis of hypertension, dyslipidemia and diabetes, and tabagism. Univariate and multivariate analyses were performed using Pearson's Chisquare test. A level of significance of 5% was adopted for all analyses. Main outcomes Number, types and proportion of resolved drug therapy problems. Results Two hundred seventy seven drug therapy problems were identified, of which 53.1% were resolved. The most frequent drug therapy problem was the "use of unnecessary drug therapy" (n=55; 19.8%). The identification of three or more drug therapy problem was higher among patients using five medications or more and among those using ten or more (p<0.05). After the delivery of medication therapy management, the proportion of patients presenting "stable" clinical status was raised from 27 to 54% (p=0.001). Conclusion CMM service demonstrates a positive impact on clinical outcomes of patients with chronic obstructive pulmonary disease and should prioritize patients with polypharmacy because they might have a higher number of drug therapy problems.