Investigation of barriers to clinical practice guideline-recommended pharmacotherapy in the treatment of COPD

Pharmacy Practice

  • Lea Price1Kaiser Permanente Colorado, Denver, CO, USA.
  • Sarah J. Billups1Kaiser Permanente Colorado, Denver, CO, USA., 2School of Pharmacy, University of Colorado at Denver and Health Sciences Center, Denver, CO, USA.
  • Melissa A. Rice1Kaiser Permanente Colorado, Denver, CO, USA., 2School of Pharmacy, University of Colorado at Denver and Health Sciences Center, Denver, CO, USA.
  • Cynthia Hartsfield1Kaiser Permanente Colorado, Denver, CO, USA., 2School of Pharmacy, University of Colorado at Denver and Health Sciences Center, Denver, CO, USA.

Volume 5 Issue 2 Pages 74-77

Abstract

Background: The adoption of clinical practice guideline recommendations for COPD is suboptimal. Determining the barriers to the implementation of these practice guidelines may help improve patient care. Objective: To determine whether barriers to the use of pharmacotherapy according to practice guidelines are related primarily to patient or prescriber factors. Methods: Retrospective cohort study. Members of a health maintenance organization identified as having spirometry-defined COPD ranging from stage II to IV. Electronic medical records were reviewed for documentation of the following: 1) patient affordability issues, 2) history of an adverse drug reaction, 3) history of inefficacy to therapy, and 4) prescription history. Results: A total of 111 medical records were reviewed. There were 51% of patients who had not filled medications that had been prescribed in accordance with guidelines and 43% did not have the guideline recommended medications prescribed in the previous year. Only 4% and 2% of patients had documented inefficacy and affordability issues, respectively. There were no reported cases of adverse drug reactions. Conclusions: This study provides insight to the acceptance of COPD treatment recommendations by patients and providers. Further research is needed to design interventions to reduce barriers and optimize COPD treatment.

Keywords

  • Pulmonary Disease
  • Chronic Obstructive
  • Practice Guidelines
  • Drug Therapy
  • Patient Compliance
  • United States
Pharmacy Practice

Loading…