Lung-2015 Baltimore, USA July , 2015 Suhaj A

Manipal College of Pharmaceutical Sciences Impact of Patient Education on Health Related Quality of Life of COPD Patients- A Randomized Controlled Study Suhaj A, Unnikrishnan MK, Mohan K Manu, Mallikarjuna Rao C Dept. of Pharmacy Practice

MANIPAL U N I V E R S I Y 3 Manipal College of Pharmaceutical Sciences MANIPAL U N I V E R S I T Y Contents Introduction Objective Methodology Results & Discussion Conclusion Acknowledgement

MANIPAL U N I V E R S I Y 4 Manipal College of Pharmaceutical Sciences MANIPAL U N I V E R S I T Y Introduction  Chronic Obstructive Pulmonary Disease (COPD), a common preventable and treatable disease.  Characterized by persistent airflow limitation that is usually progressive. 1  Second most non infectious disease, causing 2.7 million deaths annually.  There is a need to engage with all patients to get the health education, which assists them in self-care of the condition. 2 1 Global Strategy for the Diagnosis, Management and Prevention of Chronic Obstructive Pulmonary Disease. GOLD Anan S. Jarab, Salam G. AlQudah, Maher Khdour, Mohammed Shamssain, Tareq L. Mukattash. Impact of Pharmaceutical care on health outcomes in patients with COPD. Int J Clin Pharm 2012 ;34 (1):53-62

MANIPAL U N I V E R S I Y 5 Manipal College of Pharmaceutical Sciences MANIPAL U N I V E R S I T Y Introduction Contd …  Overworked physicians and paucity of trained doctors in resource-poor settings obligate task- sharing to non-physician healthcare providers.  ‘Task-sharing’ to non-physician health professionals like clinical pharmacists, besides being both feasible and less resource intensive, would go a long way in restricting the problem of COPD.  Clinical Pharmacist Intervention (CPI) can improve patients’ knowledge and awareness about the disease are important in improving quality of life.

MANIPAL U N I V E R S I Y 6 Manipal College of Pharmaceutical Sciences MANIPAL U N I V E R S I T Y Objective To evaluate the impact of patient education on Health Related Quality of Life (HRQoL) of COPD patients

MANIPAL U N I V E R S I Y 7 Manipal College of Pharmaceutical Sciences MANIPAL U N I V E R S I T Y Methodology Study site: Dept. of Pulmonary Medicine, KMC Hospital, Manipal, INDIA Study Design: An open-labeled randomized controlled study Study duration: 6 months Study population: COPD patients Materials used: St. George Respiratory Questionnaire (SGRQ). The scoring range for each component is from 0 to 100, with the lowest scores indicating the highest level of health. A change of 4 units in the mean total score has been validated as a clinically significant threshold.

MANIPAL U N I V E R S I Y 8 Manipal College of Pharmaceutical Sciences MANIPAL U N I V E R S I T Y Methodology Contd … Study Procedure:  Total patients were randomized into Control Group (CG)& Intervention Group (IG) after clearance was obtained from institutional ethics committee (IEC 88/2012).  SGRQ was administered to both the groups before and after CPI Statistical analysis: [SPSS 20 South Asia, Bangalore], Un- paired t test was used to find the significance level within the groups. Paired t test was used to assess the level of significance at follow-up. In this study p<0.05 is considered as statistically significant.

MANIPAL U N I V E R S I Y 9 Manipal College of Pharmaceutical Sciences MANIPAL U N I V E R S I T Y follow up (98) ( 6 Months) follow up (97) ( 6 Months) Control Group (103) Intervention Group (103) Total Patients (206) Outcome HRQoL (SGRQ)

MANIPAL U N I V E R S I Y 10 Manipal College of Pharmaceutical Sciences MANIPAL U N I V E R S I T Y Results & Discussion A total of 206 COPD patients (103 CG, 103 IG) were recruited into the study. Baseline demographic characteristics of the patient’s are presented in Table 1. Mean age of the study population (n=206) was 58.42± % were males. There is no significant difference in overall HRQoL between CG and IG at baseline.

MANIPAL U N I V E R S I Y 11 Manipal College of Pharmaceutical Sciences MANIPAL U N I V E R S I T Y Table 1. Baseline Demographic Characteristics of study patients

MANIPAL U N I V E R S I Y 12 Manipal College of Pharmaceutical Sciences MANIPAL U N I V E R S I T Y Post six months CPI, overall HRQoL improved in IG (5.3) compared to CG (1.2) at follow-up

MANIPAL U N I V E R S I Y 13 Manipal College of Pharmaceutical Sciences MANIPAL U N I V E R S I T Y Results & Discussion Contd … HRQoL were improved (P<0.05) in IG compared to CG after CPI in all the domains of SGRQ (Figure 2). Study population in the IG (at follow-up) has reported better HRQoL compared to the IG (at baseline) and CG (at baseline & follow-up). Similar results were reported from Anan et al and Maher et al in Jordan and United Kingdom. 2, 3 2 Anan S. Jarab, Salam G. AlQudah, Maher Khdour, Mohammed Shamssain, Tareq L. Mukattash. Impact of Pharmaceutical care on health outcomes in patients with COPD. Int J Clin Pharm 2012 ;34 (1): Maher R. khdour, Joseph C. Kidney., Bronagh M. Smyth & James C McElnay. Clinical Pharmacy –led disease and medicine management programme for patients with COPD Br J Clin Pharmacol 2009; 68:4:

MANIPAL U N I V E R S I Y 14 Manipal College of Pharmaceutical Sciences MANIPAL U N I V E R S I T Y

MANIPAL U N I V E R S I Y 15 Manipal College of Pharmaceutical Sciences MANIPAL U N I V E R S I T Y Conclusion The remarkable improvement in the HRQoL in IG at six months follow-up suggests that patient- education significantly improves HRQoL in COPD patients. Educational intervention is an economical and feasible strategy, especially in the context of the ever-increasing burden of non-communicable disease in resource-poor developing world.

MANIPAL U N I V E R S I Y 16 Manipal College of Pharmaceutical Sciences MANIPAL U N I V E R S I T Y Acknowledgement: Authors are grateful to Manipal College of Pharmaceutical Sciences, Kasturba Hospital and Manipal University, Manipal, India

MANIPAL U N I V E R S I Y 17 Manipal College of Pharmaceutical Sciences MANIPAL U N I V E R S I T Y Thank you

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