Electronic monitoring-based pharmacist-delivered counseling enhance adherence among Japanese COPD patients

Sugimori, Hiroki

Electronic monitoring-based pharmacist-delivered counseling enhance adherence among Japanese COPD patients

Wednesday, 20 August 2014

Exhibit hall (Dena'ina Center)

Hiroki Sugimori, MD , Daito Bunka University School of Sport and Health Science, Saitama, Japan

Tomoro Endo, MS , Daito Bunka University Graduate School of Sport and Health Science, Saitama, Japan

Takeshi Odajima, MS , Daito Bunka University Graduate School of Sport and Health Science, Saitama, Japan

Tomoaki Tadano, PhD , Daito Bunka University School of Sport and Health Science, Saitama, Japan

Reiko Takayasu, MS , Daito Bunka University Graduate School of Sport and Health Science, Saitama, Japan

Taiko Tanba, MS , Daito Bunka University School of Sport and Health Science, Saitama, Japan

Masaya Kasai, MS , Daito Bunka University School of Sport and Health Science, Saitama, Japan

Tomoya Kawame, BS , Daito Bunka University Graduate School of Sport and Health Science, Saitama, Japan

Michiko Yamamoto, PhD , Showa Pharmaceutical University, Tokyo, Japan

Takao Orii, PhD , NTT Medical Center Tokyo, Tokyo, Japan

INTRODUCTION: The aim of the study was to clarify whether electronic monitoring-based pharmacist-delivered counseling (EMPC) improves adherence of inhaled anticholinergic agent, Spiriva (Tiotropium Bromide) among Japanese patients with chronic obstructive pulmonary disease (COPD).

METHODS: We conducted the pharmacy-based retrospective cohort study using EMPC database. We extracted eligible 178 patients (72.6±11.8 year old; 145 male, 33 female) from February to November in 2011, who had been prescribed Spiriva for the first time. We divided patients into two groups: the interventional (INT) group whose patients received EMPC continuously regarding Spiriva at each pharmacy visit, and the control (CNT) group whose patients received only conventional pharmacists counseling. Patients were defined as dropout cases when electronic monitoring discontinued for 2 months or more from the last pharmacy visit. EMPC intervention included standardized documentation templates, pharmacists’ education in advance. The survival analysis (Kaplan-Meier methods) and the Cox proportional hazards model which adjusted patients’ profiles (age, sex) were used.

RESULTS: The median follow-up were 95 months (range: 61 to 163) in INT group, and 30 months (range: 20 to 74) in CNT group respectively. (logrank test p=0.0031, Wilcoxon test p=0.0025) INT group showed significantly lower risk than CNT group, adjusted by age and sex (Hazard Ratio (HR): 0.59; 95% Confidence Interval (CI): 0.41-0.85) over the entire follow-up period.

CONCLUSIONS: EMPC database has potential in pharmacoepidemiological research area. Although further studies are needed, our results suggested that EMPC in pharmacy might contribute to improving medication adherence in COPD patients.