IMPACT OF GOLD-GUIDED PHARMACIST-LED PHARMACEUTICAL CARE ON CLINICAL OUTCOMES AND QUALITY OF LIFE IN COPD: A PROSPECTIVE RANDOMIZED TRIAL
Author(s)
Amjad Khan, PhD1, Hafsa Kanwal, PhD2, Saima Mushtaq, PhD3, Yu Fang, PhD4;
1Xi'an Jiaotong University, Department of Pharmacy, The First Affiliated Hospital, Xi'an, China, 2Quaid-i-Azam University, Department of Pharmacy, Islamabad, Pakistan, 3Xi'an Jiaotong University, Department of Pharmacy, The First Afiiliated Hospital, Xi’an, China, 4Xi'an Jiaotong University, Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an, China
1Xi'an Jiaotong University, Department of Pharmacy, The First Affiliated Hospital, Xi'an, China, 2Quaid-i-Azam University, Department of Pharmacy, Islamabad, Pakistan, 3Xi'an Jiaotong University, Department of Pharmacy, The First Afiiliated Hospital, Xi’an, China, 4Xi'an Jiaotong University, Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an, China
OBJECTIVES: To evaluate the impact of GOLD-guided pharmacist-led pharmaceutical care on clinical outcomes and health-related quality of life in patients with chronic obstructive pulmonary disease (COPD) compared with usual care.
METHODS: A prospective, three-arm randomized clinical trial was conducted among adults with spirometry-confirmed COPD. Participants were randomly allocated (1:1:1) to usual care (Group A), pharmacist care (Group B), or comprehensive pharmaceutical care (Group C) and followed for six months. Pharmacist-led interventions were delivered in accordance with Global Initiative for Chronic Obstructive Lung Disease (GOLD) recommendations and focused on optimization of pharmacotherapy, inhaler technique, and patient education. Outcomes included COPD Assessment Test (CAT) scores, dyspnea severity, severe exacerbations, spirometric parameters, GOLD grade, and health-related quality of life assessed using the St George’s Respiratory Questionnaire (SGRQ).
RESULTS: Ninety-seven patients completed the study per protocol (Group A: n=33; Group B: n=31; Group C: n=33). Clinical outcomes improved in a clear stepwise pattern favoring comprehensive pharmaceutical care (Group C > Group B > Group A). Post-intervention CAT scores were significantly lower across all pairwise comparisons (all p<0.001). Dyspnea severity improved significantly in Groups B and C compared with Group A (p<0.001). Forced expiratory volume in one second (FEV₁) was significantly higher in Groups B and C than in Group A (p=0.001). Health-related quality of life showed significant between-group differences across total and domain-specific SGRQ scores, with Group C demonstrating the greatest clinically meaningful improvements in symptom, activity, and impact domains (all p<0.001).
CONCLUSIONS: GOLD-guided pharmacist-led pharmaceutical care, particularly comprehensive pharmaceutical care, significantly improves clinical outcomes and health-related quality of life in patients with COPD. Integration of pharmacists into multidisciplinary COPD management may enhance guideline adherence and optimize patient-centered outcomes.
METHODS: A prospective, three-arm randomized clinical trial was conducted among adults with spirometry-confirmed COPD. Participants were randomly allocated (1:1:1) to usual care (Group A), pharmacist care (Group B), or comprehensive pharmaceutical care (Group C) and followed for six months. Pharmacist-led interventions were delivered in accordance with Global Initiative for Chronic Obstructive Lung Disease (GOLD) recommendations and focused on optimization of pharmacotherapy, inhaler technique, and patient education. Outcomes included COPD Assessment Test (CAT) scores, dyspnea severity, severe exacerbations, spirometric parameters, GOLD grade, and health-related quality of life assessed using the St George’s Respiratory Questionnaire (SGRQ).
RESULTS: Ninety-seven patients completed the study per protocol (Group A: n=33; Group B: n=31; Group C: n=33). Clinical outcomes improved in a clear stepwise pattern favoring comprehensive pharmaceutical care (Group C > Group B > Group A). Post-intervention CAT scores were significantly lower across all pairwise comparisons (all p<0.001). Dyspnea severity improved significantly in Groups B and C compared with Group A (p<0.001). Forced expiratory volume in one second (FEV₁) was significantly higher in Groups B and C than in Group A (p=0.001). Health-related quality of life showed significant between-group differences across total and domain-specific SGRQ scores, with Group C demonstrating the greatest clinically meaningful improvements in symptom, activity, and impact domains (all p<0.001).
CONCLUSIONS: GOLD-guided pharmacist-led pharmaceutical care, particularly comprehensive pharmaceutical care, significantly improves clinical outcomes and health-related quality of life in patients with COPD. Integration of pharmacists into multidisciplinary COPD management may enhance guideline adherence and optimize patient-centered outcomes.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
PT36
Topic
Clinical Outcomes
Topic Subcategory
Clinical Outcomes Assessment
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)