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      Factors Affecting Community Pharmacist’s Knowledge About Chronic Obstructive Pulmonary Disease (COPD) Management in China: A Cross-Sectional Survey Study

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          Abstract

          Purpose

          Chronic obstructive pulmonary disease (COPD) has become a significant risk factor that threatens public health. Many studies have confirmed that the professional services for COPD patients by community pharmacists can improve comprehensive benefits. However, there’s less research investigating the factors affecting community pharmacists’ knowledge about COPD management. Therefore, this study aimed to investigate the knowledge of COPD among community pharmacists in China and analyze the factors affecting community pharmacist’s knowledge about COPD management.

          Methods

          This study employed a face-to-face, self-administered questionnaire survey targeting community pharmacists from three cities (Nanjing, Zhuhai, Qingyang) in China. Descriptive statistics, t-test and one-way ANOVA were used for data analysis.

          Results

          Out of the 794 pharmacists surveyed, 177 (22.3%) were completed and valid. The majority (91.0%) of participants had a positive attitude they were responsible for assisting patients to control the disease progression. Among 12 knowledge-related survey questions, only 34 (19.2%) pharmacists answered more than half of them correctly, showing that overall knowledge level of participants was generally low. The overall knowledge level was significantly ( P < 0.05) associated with higher academic education, on-the-job training, and pharmacies selling drugs for treating COPD. Regarding medical knowledge, participants got higher accuracy rates at some questions as the symptoms of COPD and identifying the main causative factors but were weak in disease characteristics and guidelines for disease diagnosis. As for medication, participants had a certain understanding of different drugs for COPD and their adverse reactions. For non-drug treatment, participants could not entirely choose the best non-drug treatment for patients, while most of them recognize the importance of pulmonary rehabilitation.

          Conclusion

          This research indicated that community pharmacists in China lacked sufficient knowledge about COPD management. It is necessary to improve university education, strengthen on-the-job training, adjust the social insurance system, and develop service guidelines for licensed pharmacists to support their professional services for COPD patients.

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          Most cited references 28

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          Prevalence and outcomes of diabetes, hypertension and cardiovascular disease in COPD.

          Chronic obstructive pulmonary disease (COPD) is associated with important chronic comorbid diseases, including cardiovascular disease, diabetes and hypertension. The present study analysed data from 20,296 subjects aged > or =45 yrs at baseline in the Atherosclerosis Risk in Communities Study (ARIC) and the Cardiovascular Health Study (CHS). The sample was stratified based on baseline lung function data, according to modified Global Initiative for Obstructive Lung Disease (GOLD) criteria. Comorbid disease at baseline and death and hospitalisations over a 5-yr follow-up were then searched for. Lung function impairment was found to be associated with more comorbid disease. In logistic regression models adjusting for age, sex, race, smoking, body mass index and education, subjects with GOLD stage 3 or 4 COPD had a higher prevalence of diabetes (odds ratio (OR) 1.5, 95% confidence interval (CI) 1.1-1.9), hypertension (OR 1.6, 95% CI 1.3-1.9) and cardiovascular disease (OR 2.4, 95% CI 1.9-3.0). Comorbid disease was associated with a higher risk of hospitalisation and mortality that was worse in people with impaired lung function. Lung function impairment is associated with a higher risk of comorbid disease, which contributes to a higher risk of adverse outcomes of mortality and hospitalisations.
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            Screening for and early detection of chronic obstructive pulmonary disease.

            Chronic obstructive pulmonary disease (COPD) is a substantially underdiagnosed disorder, with the diagnosis typically missed or delayed until the condition is advanced. Spirometry is the most frequently used pulmonary function test and enables health professionals to make an objective measurement of airflow obstruction and assess the degree to which it is reversible. As a diagnostic test for COPD, spirometry is a reliable, simple, non-invasive, safe, and non-expensive procedure. Early diagnosis of COPD should provide support for smoking cessation initiatives and lead to reduction of the societal burden of the disease, but definitive confirmation of both proves elusive. Despite substantial effort and investment, implementation of quality spirometry is deficient because of several hurdles and limitations, described in this Review. All in all, spirometry is recognised as the essential test for diagnosis and monitoring of COPD.
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              Effects of continuing medical education on improving physician clinical care and patient health: a review of systematic reviews.

              The objective of physician continuing medical education (CME) is to help them keep abreast of advances in patient care, to accept new more-beneficial care, and discontinue use of existing lower-benefit diagnostic and therapeutic interventions. The goal of this review was to examine effectiveness of current CME tools and techniques in changing physician clinical practices and improving patient health outcomes. Results of published systematic reviews were examined to determine the spectrum from most- to least-effective CME techniques. We searched multiple databases, from 1 January 1984 to 30 October 2004, for English-language, peer-reviewed meta-analyses and other systematic reviews of CME programs that alter physician behavior and/or patient outcomes. Twenty-six reviews met inclusion criteria, that is, were either formal meta-analyses or other systematic reviews. Interactive techniques (audit/feedback, academic detailing/outreach, and reminders) are the most effective at simultaneously changing physician care and patient outcomes. Clinical practice guidelines and opinion leaders are less effective. Didactic presentations and distributing printed information only have little or no beneficial effect in changing physician practice. Even though the most-effective CME techniques have been proven, use of least-effective ones predominates. Such use of ineffective CME likely reduces patient care quality and raises costs for all, the worst of both worlds.
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                Author and article information

                Journal
                Int J Chron Obstruct Pulmon Dis
                Int J Chron Obstruct Pulmon Dis
                copd
                copd
                International Journal of Chronic Obstructive Pulmonary Disease
                Dove
                1176-9106
                1178-2005
                01 December 2020
                2020
                : 15
                : 3171-3181
                Affiliations
                [1 ]State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau , Macao People’s Republic of China
                [2 ]National Licensed Pharmacist Development Research Center, China Pharmaceutical University , Nanjing City, Jiangsu Province 210009, People’s Republic of China
                Author notes
                Correspondence: Hao Hu; Carolina Oi Lam Ung State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau , TaipaN22-2057, MacaoTel +853 88228538 Email haohu@um.edu.mo; carolinaung@um.edu.mo
                [*]

                These authors contributed equally to this work

                Article
                280333
                10.2147/COPD.S280333
                7718967
                © 2020 Hu et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                Page count
                Figures: 1, Tables: 3, References: 39, Pages: 11
                Funding
                Funded by: the National Licensed Pharmacist Development Research Center at the China Pharmaceutical University;
                This work was supported by a grant from the National Licensed Pharmacist Development Research Center at the China Pharmaceutical University (under Grant No. ndrplc201901).
                Categories
                Original Research

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