Using Pharmacist-Led Tele-Consultation to Review Patients with Chronic Obstructive Pulmonary Disease

Abstract

Introduction: A feasibility study was conducted with patients randomised to intervention arm or treatment as usual, in a community pharmacy-based chronic obstructive pulmonary disease (COPD) clinic. The study aimed to establish further work required to proceed to a definitive trial to test the impact of pharmacist interventions via Tele-Consultations (TC) amongst patients with COPD. The objectives were to determine feasibility of the rate of patient recruitment, retention, acceptability of TC, practicalities and completeness of data collection for outcome measures used to assess COPD control and management. Methods: Conducted in a single pharmacy by one specialist respiratory pharmacist (SRP) (community pharmacist with qualification in respiratory therapy). Patients were recruited from the pharmacy customer base and local advertisements. Participants were >35 years, with clinician diagnosed COPD and able to communicate in English. Participants were randomised (1:1) to receive an in-person consultation (IPC) or TC after spirometry, oximetry, and BMI measurements in-person. Consultations comprised of COPD review, education and medication optimisation - communicated to prescriber via postal mail. After 6-months, all participants were reassessed in-person. Results: Forty-eight patients from 16 GP practices were recruited over 4-months; 41 (85%) completed the study. At follow-up, 29% of participants in the TC group declared a preference for IPC. Collection of data on all outcomes were completed with no adverse events. Conclusion: The recruitment target was met by employing additional strategies and achieved a satisfactory retention rate. Acceptability of the process of conducting TCs and the completeness of data collection was confirmed. Further studies should pilot a multi-centred approach with more pharmacists and employing an integrated approach with GPs, in preparation for a definitive study.