Wpływ opieki farmaceutycznej na wyniki leczenia astmy i POChP: metaanaliza wyników klinicznych i przestrzegania farmakoterapii

PURPOSE: This meta-analysis aimed to evaluate the effectiveness of pharmaceutical care in managing asthma and chronic obstructive pulmonary disease (COPD), focusing on clinical outcomes, medication adherence, and quality of life. PATIENTS AND METHODS: Randomized controlled trials comparing asthma or COPD patients who received pharmaceutical care intervention on the basis of the original treatment and the control group who only received the original treatment were included. The main results include Asthma Control Test (ACT); COPD Assessment Test (CAT); modified Medical Research Council (mMRC) dyspnea scale. Secondary outcomes were medication adherence; correct rate of inhaler technique; emergency room visit; hospitalization; Asthma Quality of Life Questionnaire (AQLQ); Peak Expiratory Flow Rate (PEFR, L/min). All analyses used a random - effects model. RESULTS: A total of 18 randomized controlled trials involving 4173 patients were included. The results showed that in the pharmaceutical care group, the mean correct inhalation technique rate (OR = 6.53, 95% CI: [3.19, 13.37], P < 0.001), medication adherence (OR = 1.45, 95% CI: [1.03, 2.03], P = 0.031), and the number of patients with better asthma control as indicated by ACT results (OR = 2.51, 95% CI: [2.51, 4.35], P < 0.01) were significantly better than those in the control group. The emergency room visit rate (OR = 0.44, 95% CI: [0.29, 0.67], P < 0.001) and hospital admissions rate (OR = 0.27, 95% CI: [0.19, 0.39], P < 0.001) were significantly lower. The PEFR of patients was better (SMD = 0.37, 95% CI: [0.09, 0.6], P < 0.01). However, no significant changes were observed in CAT, AQLQ, or mMRC. CONCLUSION: Pharmacists' interventions exert a positive effect on asthma and COPD management outcomes, though improved research design and quality are still needed.