Community pharmacists’ knowledge of COPD, and practices and perceptions of medication counseling of COPD patients

International Journal of COPD Dovepress open access to scientific and medical research Original Research International Journal of Chronic Obstructive Pulmonary Disease downloaded from https://www.dovepress.com/ by 5.135.254.153 on 12-Jul-2018 For personal use only. Open Access Full Text Article Community pharmacists’ knowledge of COPD, and practices and perceptions of medication counseling of COPD patients This article was published in the following Dove Press journal: International Journal of COPD Juha Markus Heikkilä 1,2 Stina Parkkamäki 3 Johanna Salimäki 4 Sari Westermarck 5 Marika Pohjanoksa-Mäntylä 1 Faculty of Pharmacy, Division of Pharmacology and Pharmacotherapy, University of Helsinki, Helsinki, Finland; 2Hartola Pharmacy, Hartola, Finland; 3Hyvinkää Willan Kehrä Pharmacy, Hyvinkää, Finland; 4The Association of Finnish Pharmacies, Helsinki, Finland; 5Tammela Pharmacy, Tammela, Finland 1 Background and purpose: COPD is one of the leading causes of morbidity and mortality worldwide. Although medication counseling interventions by pharmacists have been found to support the management of COPD, little is known about pharmacists’ knowledge concerning COPD and regular practices and perceptions concerning medication counseling of COPD patients. The purpose of this study was to research these topics among Finnish community pharmacists. Materials and methods: In January 2017, an electronic survey was e-mailed to Finnish community pharmacies (n=741) via the Association of the Finnish Pharmacies. One pharmacist from each pharmacy, preferably a specialist in asthma, was invited to answer the survey. Results: Completed responses were received from 263 pharmacists (response rate =35%), of whom 196 pharmacists were specialists in asthma. Response rate among asthma pharmacists was 42%. Pharmacists were positive about their role in medication counseling and in support of the self-management of COPD patients. COPD-related knowledge was self-assessed as being good and was on a good level in respect of basic facts. However, almost half (46%) of the pharmacists did not know that COPD is considered a national public health issue, and ~50% of the pharmacists were not familiar with the current care guideline on COPD. Medication counseling was found to be more medicinal product-driven and less advisory concerning lifestyle changes such as smoking cessation and physical exercise. Conclusion: Although the pharmacists’ knowledge of COPD was good on general topics, there were some gaps in their knowledge on the current care guideline and status of the disease. Pharmacists should more systematically individually target medication counseling according to patients’ needs. In addition, lifestyle treatments, including smoking cessation and physical exercise, should be part of the medication counseling. Keywords: pulmonary disease, medication counseling, pharmacists, clinical practice guideline, knowledge Introduction Correspondence: Juha Markus Heikkilä Faculty of Pharmacy, University of Helsinki, Viikinkaari 5 E, PO Box 56, 00014 Finland Tel +358 40 021 9232 Email 2065 submit your manuscript | www.dovepress.com International Journal of COPD 2018:13 2065–2074 Dovepress © 2018 Heikkilä et al. This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php). http://dx.doi.org/10.2147/COPD.S159726 Powered by TCPDF (www.tcpdf.org) COPD is one of the leading causes of morbidity and mortality worldwide, and in Western societies, the prevalence of COPD is mostly related to smoking.1 However, between 1990 and 2010, the total number of COPD deaths was decreasing globally in all age-groups.2 In Finland, the prevalence of COPD is between 3.7% and 9%, and COPD is recognized as an important public health issue by the National Institute of Health and Welfare.3–7 According to the global strategy for diagnosis, management, and prevention of COPD and several European guidelines, diagnostics of COPD should be improved.1,8–11 Dovepress International Journal of Chronic Obstructive Pulmonary Disease downloaded from https://www.dovepress.com/ by 5.135.254.153 on 12-Jul-2018 For personal use only. Heikkilä et al Lifestyle changes such as smoking cessation and physical exercising are important nonpharmacological ways of treating COPD. COPD medicines are used to relieve symptoms, such as dyspnea and to prevent exacerbations.1,8–11 Appropriate nutrition and nutrition counseling based on the patient’s individual needs should be part of treatment,8,9 and influenza and pneumococcal vaccines are recommended for COPD patients.1,8–11 The role of pharmacists has been recognized in the treatment of COPD patients, including actions from primary prevention (eg, educational campaigns), through preliminary diagnostics (eg, microspirometry testing), to ongoing support and follow-up of patients and their medications.6 Special medication counseling interventions by community pharmacists are found to have a positive impact on patient and treatment outcomes among COPD patients.7–9 Two interventions in the Netherlands identified that active medication counseling by community pharmacists was a contributing factor in reducing drug-related problems and improving the quality of life among COPD patients.7,8 In addition, acute exacerbations of COPD were found to decrease when comparing preintervention and postintervention data after a year of medication counseling intervention.8 Similarly, in the UK, the patients who were assigned a special 10-week period of medication counseling support from their community pharmacists were found to be more adherent to their COPD medications, to experience better health-related quality of life and to use less general practitioner services compared with the patients who received standard counseling.9 In Finland, community pharmacists are obliged by law to administer verbal medication counseling while dispensing medicines to ensure safe and effective pharmacotherapy.16 In addition to medication counseling, other health promotion–related professional services, such as special asthma, smoking cessation, and diabetes services, and medication reviews are provided by community pharmacies.17 Since 1997, the patients with respiratory diseases have been particularly focused upon by Finnish community pharmacists when pharmacies joined the National Asthma Program. In participating pharmacies, specific asthma pharmacists were named and educated to (...truncated)