Guidance for COPD patients leads to better use of inhaled medication

COPD, or chronic obstructive pulmonary disease, is a long-term condition in which the airways become narrowed, usually due to smoking or exposure to harmful substances. This leads to symptoms such as shortness of breath, chronic coughing, mucus production, and fatigue. COPD often includes both chronic bronchitis and emphysema. Although the disease cannot be cured, medication via inhalers, smoking cessation, and proper support can alleviate symptoms and improve quality of life. Correct use of inhaled medication is essential in this case.

Patients who receive intensive support from a hospital pharmacist during their hospital stay use their inhaled medication more accurately and confidently. This is evident from a study by Annelies I.M. Walravens and Emma Walravens (Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel), in collaboration with colleagues from institutions including the Queen Elisabeth Institute in Oostduinkerke. The study also demonstrates that the protocol used is feasible in clinical practice and widely supported by healthcare providers.

"Most studies start from a hypothesis, but our idea came from practical experience," says Annelies Walravens. "We saw that patients with COPD often struggle with using their inhalers correctly. Our study showed that intensive, step-by-step guidance from a pharmacist can really make a difference."

The research builds on previous work by Professor Eline Tommelein, who investigated the impact of pharmaceutical support in community pharmacies. "In our study, we adapted that model to a hospital setting—specifically, the Queen Elisabeth Institute, which specializes in the rehabilitation of lung patients," explains Emma Walravens. "We followed up each patient a total of six times, spread throughout their hospital stay and the weeks afterward."

The study not only showed an improvement in inhaler use but also indicated that patients felt empowered. "For many patients, this was the first time they received such a comprehensive explanation of their medication," says Stephanie Wuyts of the VUB Research Centre for Digital Medicine. "They greatly appreciated the personal attention, which certainly improved their medication adherence."

Healthcare providers also supported the initiative. "During a focus group at the end of the process, it became clear that doctors, nurses, IT staff, and other employees recognized the added value of the protocol," says Sander Boudewyn of the Queen Elisabeth Institute. "They saw it as a realistic, yet valuable addition to healthcare."

The feasibility of this type of intervention is further enhanced by the use of support services. Kayleigh Spriet, also from the Queen Elisabeth Institute: "With a good division of labor and IT support, pharmacists can focus on where they make the difference: education and follow-up."

According to Dr. Kristel De Paepe, a pulmonologist at the Queen Elisabeth Institute, the project's strength lies in the collaboration. "This study truly demonstrated that multidisciplinary collaboration improves patient care. And that pharmacists can play a central role in this."

VUB Prof. Eline Tommelein VUB concludes: "What began as a pilot project now forms a strong foundation for a structural approach within hospitals. The results provide tools to structurally improve medication adherence — and therefore also the patient's quality of life."