Impact of community pharmacists in COPD management: Inhalation technique and medication adherence

BACKGROUND: Inhalation technique and medication adherence are highly important for the management of chronic obstructive pulmonary disease (COPD) since they are essential pre-requisites for achieving full therapeutic effect in patients. Community pharmacists are in the best position to deliver services in these two areas. METHODS: This is a ten-year period review of studies looking into the impact of community pharmacists in the management of COPD in relation to: inhalation technique and medication adherence in the period from 2005 to 2015. RESULTS: Ten studies are included in the review. The studies show that community pharmacists' interventions had a positive impact on improving patients' inhalation technique and adherence to inhaled medications. This was shown in some studies to be cost-effective in terms of reducing hospitalisation and severe exacerbation rate. Scarcity of studies in this domain is noted through this review. CONCLUSIONS: This review showed that community pharmacists can have a positive impact in the management of COPD especially on inhaler technique education and medication adherence. Nevertheless, their role is still not fully recognised in this area, thus there is a need for more research. There is also a need for more research to identify the optimal frequency for inhaler technique re-checking and education as a pre-emptive measure against technique deterioration in patients. The results highlight the need for healthcare systems to recognise more the role of community pharmacists in COPD management in two critical areas that are still challenging in real practice.