Late Breaking Original Research
Tuesday, October 15, 2024
08:30 AM–10:00 AM
Abstract
Introduction: Chronic obstructive pulmonary disease (COPD) is a progressive respiratory disease characterized by breathlessness, cough, and mucus production. Patients’ COPD symptoms are persistent and can acutely worsen, leading to life-threatening disease flares, termed exacerbations. International guidelines outline best practices to improve patient COPD symptoms; however, only one-third of patients receive guideline-directed therapy.
Research Question or Hypothesis: This evaluation explores the impact of pharmacists providing COPD best practices and medication management interventions on Veteran symptom improvement through a COPD primary care service.
Study Design: A program called COPD Coordinated Access to Reduced Exacerbations (COPD CARE) was created within the Department of Veterans Affairs to optimize the delivery of COPD best practices using pharmacists. The program aimed to improve the health outcomes of Veterans by implementing evidence-based practices tailored to COPD management. Service data from 328 Veterans who received the COPD CARE service were obtained from September 2020 to February 2024.
Methods: Veterans enrolled in the COPD CARE program received an initial Wellness Visit, during which best practices and interventions were delivered, and baseline COPD symptoms were measured. Symptoms were assessed using the COPD Assessment Test (CAT), measuring the impact of eight COPD symptoms on a patient’s health, with scores ranging from 0 (best) to 40 (worst). Symptoms were measured again one month after the initial Wellness Visit. To evaluate the association between these interventions and symptomatic improvement, a chi-squared test of independence was conducted.
Results: A mean CAT score improvement of 3.2 points was observed between the Wellness Visit and subsequent visit [95% CI, -4.0 to -2.6]. Veterans who received a medication change by pharmacists were more likely to have a clinically meaningful >2 point CAT score improvement (p<0.001).
Conclusion: The associations between medication changes made by pharmacists and COPD symptom improvement further promotes the role of pharmacists to optimize COPD management in primary care settings.
Presenting Author
Dylan Erdelt PharmD StudentUniversity of Wisconsin - Madison School of Pharmacy
Authors
Michelle Chui PharmD, PhD
University of Wisconsin - Madison School of Pharmacy
Steven Do PharmD Student
University of Wisconsin - Madison School of Pharmacy
Lucas Donovan MD, MS
Veterans Affairs Puget Sound Health Care System
Scott Hetzel MS
University of Wisconsin-Madison
Pramit Maskey BS
Seattle VA Medical Center
M Shawn McFarland PharmD, FCCP, BCACP
Veterans Affairs Tennessee Valley Healthcare System
Heather Ourth PharmD, BCPS, BGCP
Tiffany Parham MS, PharmD Student
University of Wisconsin - Madison School of Pharmacy
Edward Portillo PharmD
University of Wisconsin-Madison School of Pharmacy
Rena Steiger-Chadwick MPH
Hines VA Hospital
Jenna Vande Hey PharmD Student
UW-Madison School of Pharmacy
Sarah Will PharmD, BCPS, BC-ADM
Department of Veterans Affairs Clinical Pharmacy Practice Office