Systematic review and meta-analysis of pharmacist-led care in COPD
Photo by Bermix Studio / Unsplash
Key Takeaway
Consider that pharmacist-led COPD care may reduce admissions and improve adherence, but evidence is heterogeneous and limited.
This systematic review and meta-analysis evaluated pharmacist-led interventions in COPD patients, pooling data from 2313 participants across included trials. The authors synthesized evidence on exacerbation-related hospital admissions, medication adherence, smoking cessation rates, health-related quality of life, COPD Assessment Test scores, and lung function.
The analysis reported a lower risk of exacerbation-related hospital admissions with pharmacist-led care (RR = 0.43; 95% CI: 0.33-0.55). Improvements were observed in medication adherence and smoking cessation rates, and health-related quality of life was reported to improve. In contrast, COPD Assessment Test scores and lung function showed non-significant effects.
The authors noted several limitations: substantial heterogeneity, variable overall study quality, many small trials, and a high risk of bias in many trials. They highlighted inconsistent effects across outcomes and concluded that the evidence is heterogeneous and limited by study quality.
In terms of practice relevance, the authors suggested that pharmacist-led interventions in COPD may improve selected medication-related and patient-centered outcomes. However, they emphasized that robust conclusions regarding clinical effectiveness and effects on COPD Assessment Test scores and objective disease measures cannot be drawn, and findings should be interpreted cautiously.
More on Chronic Obstructive Pulmonary Disease
Ultrasound-facilitated catheter-directed alteplase reduces early recurrence in intermediate-risk pulmonary embolism
New trial shows ultrasound-guided clot-busting drugs help some patients with serious lung clots recover faster and safely
This randomized controlled trial evaluated ultrasound-facilitated, catheter-directed fibrinolysis with alteplase plus anticoagulation versus…
A large study found that using ultrasound to guide clot-busting medicine helped patients with serious lung clots avoid bad outcomes. The tre…
Network meta-analysis of exercise interventions for COPD rehabilitation
Two specific exercises improved lung function and quality of life in COPD patients
This systematic review and network meta-analysis synthesized evidence on single exercise interventions for patients with chronic obstructive…
A large review found that water-based Liuzijue and Yijinjing exercises offered the biggest gains for lung function and daily life in people …
Case report details multimodal treatment for aggressive thyroid carcinoma
First new treatment combination in six months stabilizes advanced thyroid cancer
A 61-year-old man with papillary thyroid carcinoma achieved disease stabilization after thyroidectomy, radiotherapy, and targeted therapy. T…
A 61-year-old man with advanced thyroid cancer saw his disease stop growing after a specific mix of treatments within six months of his diag…
Meta-analysis identifies rare gene-trait associations across 1.2 million individuals in global biobanks
Scientists found many rare gene links to health traits using global data from millions of people
This meta-analysis of gene-based data from over 1.2 million individuals across diverse ancestries examines rare coding variation. The author…
A big study looked at rare gene changes in over 1.2 million people from many backgrounds. It found many links to diseases that single groups…
View Original Abstract ↓
PURPOSE: Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of morbidity and mortality worldwide, and suboptimal medication management contributes to exacerbations and preventable healthcare utilization. Pharmacist-led integrated care has the potential to improve medication use and clinical outcomes. We conducted a systematic review and meta-analysis to evaluate the effects of pharmacist-led interventions in COPD.
METHODS: This systematic review and meta-analysis was conducted and reported in accordance with PRISMA 2020. We searched PubMed, Embase, and Web of Science from inception until June 23, 2025. Randomized controlled trials (RCTs) assessing the effects of pharmaceutical care on clinical outcomes in COPD patients were included. A random-effects model was used to estimate pooled relative risks (RRs) or mean differences (MDs) with 95% confidence intervals (CIs). Risk of bias was assessed using the Cochrane Risk of Bias tool.
RESULTS: A total of 11 randomized controlled trials involving 2313 participants were included. Pharmacist-led interventions were associated with a lower risk of exacerbation-related hospital admissions (RR = 0.43, 95% CI: 0.33-0.55). Improvements in medication adherence and higher smoking cessation rates were also observed. Improvements in health-related quality of life were reported; however, substantial heterogeneity was present. In contrast, effects on COPD Assessment Test scores and objective disease measures, including lung function, were non-significant. Overall study quality was variable, with many trials being small and at high risk of bias.
CONCLUSION: Pharmacist-led interventions in COPD may improve selected medication-related and patient-centered outcomes; however, the available evidence is heterogeneous and limited by study quality and inconsistent effects across outcomes. These findings should be interpreted cautiously, and well-designed, adequately powered trials with standardized outcomes are needed before robust conclusions regarding clinical effectiveness can be drawn.
Real-world meta-analysis supports pembrolizumab for advanced NSCLC with high PD-L1
Real-world data confirms pembrolizumab offers long-term survival for advanced lung cancer patients
Related in Pulmonology & Critical Care
Systematic review links specific TCM constitutions to worse COPD outcomes in 2,168 patients
TCM Constitution Types Linked to Worse COPD Outcomes
This systematic review and network meta-analysis examined Traditional Chinese Medicine (TCM) constitutions in 2,168 COPD patients. The autho…
A large analysis of 2,168 COPD patients found that specific Traditional Chinese Medicine constitution types were linked to lower lung functi…
Subcutaneous astegolimab reduced COPD exacerbations in phase 2b and 3 trials versus placebo
New drug cuts COPD flare-ups for some smokers in large trials
This randomized, double-blind, placebo-controlled phase 2b and 3 trial evaluated subcutaneous astegolimab in current or former smokers with …
A new medicine called astegolimab reduced severe breathing flare-ups for some people with COPD, though results varied by how often they took…
Case report of 3-year-old girl with bilateral Wilms tumor and TP53 mutation treated with VAD chemotherapy and surgery
3-year-old girl with TP53 mutation and bilateral Wilms tumor died after treatment
This case-based review describes a single 3-year-old girl with bilateral Wilms tumor and a TP53 mutation treated under the Chinese Children …
A single case report describes a 3-year-old girl with bilateral Wilms tumor and a TP53 mutation who died despite aggressive chemotherapy and…
Delayed arousal timing links to higher mortality in sleep apnea patients
Timing of breathing pauses predicts death risk in obstructive sleep apnea
A meta-analysis found that each one-second delay in post-apnea arousal peak time was associated with increased all-cause and cardiovascular …
New analysis shows how late a breathing pause wakes you up predicts higher death risk for men with obstructive sleep apnea.
From Other Specialties
Probiotics, synbiotics, and berberine modestly lower fasting glucose and HbA1c in type 2 diabetes
Probiotics and Berberine Modestly Lower Blood Sugar in Type 2 Diabetes
This meta-analysis of over 2,000 participants found that probiotics, synbiotics, and berberine produced significant but modest reductions in…
Probiotics, synbiotics, and berberine may help lower blood sugar and HbA1c, but the effects are modest.
High-dose ocrelizumab 1200/1800 mg shows no significant difference in disability progression versus 600 mg in MS
High-dose ocrelizumab did not further reduce disability progression in multiple sclerosis patients
This phase 3b randomized controlled trial in 860 and 753 patients with relapsing or primary progressive multiple sclerosis found that high-d…
A large trial found that higher doses of ocrelizumab did not lower the risk of disability progression compared to the standard dose in multi…
Ocrelizumab reduces disability progression risk in primary progressive multiple sclerosis versus placebo
Ocrelizumab reduces disability risk for primary progressive multiple sclerosis patients
This phase 3b trial evaluated intravenous ocrelizumab versus placebo in patients with primary progressive multiple sclerosis. The study foun…
A large trial found ocrelizumab significantly lowers the risk of disability progression in patients with primary progressive multiple sclero…
Prasinezumab showed non-significant delay in motor progression versus placebo in early-stage Parkinson's disease
Early Parkinson's drug trial shows no delay in motor progression
This phase 2b trial evaluated intravenous prasinezumab in individuals with early-stage Parkinson's disease on stable medication. The study f…
A Phase 2b trial of prasinezumab in early Parkinson's disease failed to meet its primary endpoint of delaying motor progression compared to …