Study: Pharmacy Care Plans to Reduce COPD Exacerbations


A poster presentation from ASHP Midyear 2020 Clinical Meeting & Exhibition highlighted the pharmacist’s role in improving outcomes in patients with COPD.


Research presented at the American Society of Health-System Pharmacists (ASHP) Midyear 2020 Clinical Meeting & Exhibition determined methods for improving pharmaceutical care plans for patients with chronic obstructive pulmonary disease (COPD) to prevent hospital readmissions. 

In the poster presentation, study author Daniel Joseph Grixti, pharmacist from the University of Malta, explained that preventing exacerbations that lead to hospitalization in patients with COPD is key to improving outcomes. As such, the study aimed to determine what factors lead to exacerbation of COPD, causing hospitalization or readmission, and how pharmacists are equipped to address them.

The 3-phase case-control study took place at Mater Dei Hospital, using a questionnaire-based interview in phase 1. Fifty-eight patients with confirmed COPD were allocated into 1 of 2 cohorts, either the inpatient cohort or the control group, which included patients who were not hospitalized during the previous year.

Based on the information compiled in phase 1, the authors created an evidence-based data collection tool for phase 2 that was tested for feasibility and applicability on the first 10 patients recruited among the inpatient and outpatient cohorts. In phase 3 of the study, researchers incorporated the tool in clinical scenarios, analyzing data through IBM SPSS version 26.

According to Grixti, the developed “COPD exacerbation risk factors management and prevention” tool was used to assist in developing an individualized pharmaceutical care plan, with 3 sections targeting various aspects in COPD care and management:

Section A: General data collection of patient-specific factors and COPD-specific variables, such as patient demographics, medication reconciliation, environmental factors, health care professionals involved, spirometry results, smoking history, and seasonality

Section B: Inhaler adherence assessment and patient behavior amid worsening COPD symptoms

Section C: Evaluations of inhaler and nebulizer administration techniques

Grixti reported that by identifying contributing factors to COPD exacerbations, the authors were able to create an evidence-based pharmaceutical care model with a goal of improving transition of care, with the most fundamental areas being:

  1. Device-specific inhaler technique difficulties and misconceptions
  2. Written self-management action plans for worsening symptoms
  3. Optimization of comorbidities management

Implications of the research could “ultimately benefit patients and the national health care system,” Grixti concluded.

For more coverage of the ASHP Midyear 2020 Clinical Meeting & Exhibition, click here.


  1. Grixti DJ, Montefort S, Grech L, et al. Pharmacists’ interventions in COPD related hospital readmissions. Presented at: ASHP Midyear 2020 Clinical Meeting & Exhibition; December 7, 2020. Virtual. Accessed December 8, 2020.

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