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Pharmacist-Led Integrated Management for Patients with Chronic Obstructive Pulmonary Disease: A Systematic Review and
Xinyi Li1,2, Xuedi Ma3, Wangjun Qin2
1China-Japan Friendship Hospital (Institute of Clinical Medical Sciences), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China.
Summary
Pharmacist-led interventions for Chronic Obstructive Pulmonary Disease (COPD) may reduce hospitalizations and improve adherence. However, evidence quality is variable, necessitating further high-quality trials for definitive conclusions on COPD management.
Area of Science:
- Pulmonary Medicine
- Clinical Pharmacy
- Evidence Synthesis
Background:
- Chronic Obstructive Pulmonary Disease (COPD) significantly contributes to global morbidity and mortality.
- Suboptimal medication management in COPD exacerbates the condition and increases healthcare utilization.
- Integrated care models, particularly those led by pharmacists, show promise for enhancing medication use and patient outcomes.
Purpose of the Study:
- To systematically review and meta-analyze the impact of pharmacist-led interventions on clinical outcomes in patients with COPD.
- To evaluate the effectiveness of pharmaceutical care in managing COPD exacerbations and improving patient adherence.
Main Methods:
- A systematic review and meta-analysis adhering to PRISMA 2020 guidelines.
- Searched major databases (PubMed, Embase, Web of Science) for randomized controlled trials (RCTs) up to June 2025.
- Employed a random-effects model for meta-analysis and assessed risk of bias using the Cochrane tool.
Main Results:
- Eleven RCTs with 2313 participants were included.
- Pharmacist-led interventions significantly reduced exacerbation-related hospital admissions (RR=0.43).
- Improvements were noted in medication adherence and smoking cessation rates, though quality of life improvements showed heterogeneity. No significant impact on COPD Assessment Test scores or lung function was observed.
Conclusions:
- Pharmacist-led interventions show potential for improving specific medication-related and patient-centered outcomes in COPD.
- The current evidence is limited by heterogeneity and study quality, with inconsistent effects across various outcomes.
- Further well-designed, adequately powered trials with standardized outcomes are required to establish definitive clinical effectiveness.
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