Pharmacists’ interventions in COPD related hospital readmissions

Abstract

Exacerbation of COPD defined as acute worsening of respiratory symptoms is associated with accelerated disease progression, often leading to hospitalisations impacting patients’ quality of life, mortality, and morbidity, and national healthcare systems. A key component in the management of COPD is prevention of exacerbations (GOLD, 2020) 1 which are not only of significant detriment to the patient but consume a considerable portion of healthcare expenditure. The Centre for Disease Control and Prevention estimate that by 2020 COPD expenditure will increase to $49 billion. 2 The European Respiratory Society reported that the annual cost of respiratory disease in the EU zone amounts to over €380 billion of which €48 billion can be attributed to COPD related healthcare and lost productivity costs. 3 Previous studies conducted in Malta focused on different aspects of COPD management other than on understanding factors responsible for increased risk of exacerbations necessitating hospitalisation. The rationale of this research is formulated on an attempt to identify variables contributing towards exacerbation of COPD which lead to hospitalisation whilst highlighting the contribution of the pharmaceutical service provision. The acute general teaching hospital, Mater Dei Hospital which is the main public hospital of the Maltese islands provided the research setting. The hospital offers inpatient and outpatient services in addition to specialised clinics including respiratory clinics.