Effect of Collaboration between a Community Pharmacist and Physical Therapist on Patients with COPD

Abstract

Patients with chronic obstructive pulmonary disease (COPD) have difficulty inhaling bronchodilator medication due to dyspnea. We investigated whether collaboration between community pharmacists and physical therapists at a respiratory clinic (COLLAB) that provides breathing exercises and inhalation instructions to COPD patients resulted in improved breathing techniques and respiratory indices.

Indices including the breathing technique scores of exhalation, inhalation, inspiratory length, and breath hold (poor 0, good 8); forced expiratory volume in one second (FEV₁); COPD assessment test (CAT) score (good 0, poor 40); and six-minute walk test (6MWT) were measured at 0 and 3 months after COLLAB.

Thirty-nine patients participated in the study. The median breathing technique score improved significantly in patients with stages Ⅰ and Ⅱ COPD (0-month 6.0 vs 3-month 8.0, P < 0.001) and patients with stages Ⅲ and Ⅳ COPD (0-month 3.0 vs 3-month 7.0, P < 0.001). The median 6MWT increased to a greater extent in patients with stages Ⅰ and Ⅱ COPD and improved the breathing techniques score (4 - 8 points) more than in patients with a slightly improved score (0 - 3 points) (48 m vs 0 m, P = 0.005). Patients with stages Ⅲ and Ⅳ COPD also had a greater increase in the median FEV₁ (0.02 L vs -0.10 L, P = 0.013) and decrease in the median CAT score (-3.0 vs 1.0, P = 0.024).

COLLAB improved the breathing technique scores, with patients achieving significant improvement in techniques having improved clinical indices. Therefore, COLLAB is important to achieve the full effect of inhalation medication in COPD patients.