Meta-analysis shows pharmaceutical care improves asthma and COPD management outcomes in 4173 patients
This meta-analysis examined the impact of pharmaceutical care interventions compared to original treatment only in a population of 4173 asthma or COPD patients. The study synthesized data on multiple outcomes including the Asthma Control Test, COPD Assessment Test, and modified Medical Research Council dyspnea scale. Secondary outcomes covered medication adherence, inhaler technique, emergency room visits, hospitalization, asthma quality of life, and peak expiratory flow rate.
The analysis reported that the correct inhalation technique rate was significantly better in the pharmaceutical care group with an odds ratio of 6.53 and a 95% confidence interval of [3.19, 13.37]. Medication adherence was also significantly better with an odds ratio of 1.45 and a 95% confidence interval of [1.03, 2.03]. Better asthma control was indicated by ACT results with an odds ratio of 2.51 and a 95% confidence interval of [2.51, 4.35].
Adverse events, serious adverse events, discontinuations, and tolerability were not reported. The emergency room visit rate was significantly lower with an odds ratio of 0.44 and a 95% confidence interval of [0.29, 0.67]. Hospital admissions were significantly lower with an odds ratio of 0.27 and a 95% confidence interval of [0.19, 0.39]. Peak expiratory flow rate showed improvement with a standardized mean difference of 0.37 and a 95% confidence interval of [0.09, 0.6]. No significant changes were observed for CAT, AQLQ, or mMRC. The authors state that improved research design and quality are still needed.