Chronic Obstructive Pulmonary Disease
Conditions
Brief summary
Hypothesis: Can a counseling intervention, delivered by a pharmacist, increase inhaler adherence in veterans with COPD who have demonstrated poor inhaler adherence through pharmacy refill records? Veterans who receive who receive daily maintenance inhalers from the William S Middleton Memorial Veterans Hospital Pharmacy and who have a medication possession ratio less than 80% over the previous six months will be invited to participate in the study. This study will randomize 100 participants to a usual care arm or a pharmacist counseling intervention. Final data collection will be six months after randomization to determine if both self-reported and refill record adherence has changed.
Interventions
BEHAVIORALCOPD Inhaler Counseling
The counseling will be performed via telephone by a pharmacist at the William S Middleton Memorial Veterans Hospital. The counseling will include education about inhaled COPD medication, inhaler technique review, reminder tools, and motivational interviewing.
BEHAVIORALUsual Pharmacy Care
The usual care arm will receive standard care from the William S Middleton Memorial Veterans Hospital pharmacists.
Sponsors
William S. Middleton Memorial Veterans Hospital
American Society of Health-System Pharmacists
University of Wisconsin, Madison
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Investigator)
Eligibility
Sex/Gender
ALL
Age
60 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Male and female veterans established with the William S. Middleton Memorial Veterans Hospital and associated Community Based Outpatient Clinics * Fill their inhaled COPD medications with the VHA * A diagnosis of COPD and an active prescription for a twice daily long-acting beta-agonist and/or long-acting anticholinergic with or without a prescription for inhaled corticosteroids for at least 4 months. * Non-adherence to at least one COPD medication, a medication possession ratio of less than 80% or over 120% via the pharmacy refill records.
Exclusion criteria
* Patients with a diagnosis or electronic medical record note regarding significant hearing impairment. * Patients with a diagnosis regarding cognitive deficit and activated power of attorney. * Patients who use daily nebulization instead of inhalers for maintenance medication.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Adherence to daily inhaled COPD medications | Previous six months | Adherence will be measured by pharmacy refill records and by participant self-report |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| COPD exacerbations | Previous six months | Participants will be asked how many episodes of worsening their COPD has required additional medical care and/or the use of an oral steroid or antibiotic. |
Countries
United States
Outcome results
None listed