Background and Importance Lung disease prevalence in the prison population is higher than in the general population of the same age. Pharmaceutical care detects and reduces drug-related problems by helping in therapy optimisation and improving treatment adherence.
Aim and Objectives 1/ To improve the bronchodilator treatment of patients with asthma or chronic obstructive pulmonary disease (COPD) in prison.
2/ To identify patients with low adherence in order to check the patient’s inhalation technique and ensure proper administration.
Material and Methods Observational, descriptive and retrospective study of patients with asthma and/or COPD diagnosis in August 2022. Demographic data (age, sex), clinical data (body mass index, smoking habit, presence of exacerbations) and type of treatment were collected. Adherence was calculated through dispensing records (packages collected/packages prescribed) between August 2021 and August 2022. Adherent patient was defined if they had 100-80% of dispensations, non-adherent if they had <80%, and poorly controlled due to bronchodilator treatment abuse if they had >100%.
Results 46 (6.7%) patients under bronchodilator treatment were identified out of 686 prisoners. 10 patients were excluded because they were not chronic treatment. The 36 selected patients had a mean age of 40 ± 9 years and 8.3% were women. 28 patients had asthma diagnosis, 6 COPD diagnosis and 2 had mixed pattern. 33 patients were smokers and 24 were overweight or obese.
Bronchodilator treatment could be optimised in 16/36 (44.4%) of patients: 10 patients with asthma (5 without inhaled short-acting bronchodilator (SABA) and 5 used inhaled corticosteroids), and 6 patients with COPD (3 used SABA as maintenance treatment and 3 used inhaled corticosteroids without exacerbations over the last year). 28/36 patients required pharmaceutical care to improve patient’s inhalation technique (23 non-adherent and 5 treatment overuse).
Conclusion and Relevance Pharmacists play a key role to optimise complex therapies. This study shows us that almost half of bronchodilator treatments in prison can be optimised, and more than three quarters of the population have poor adherence. A specific pharmaceutical care programme in prison should be carried out to identify drug-related problems.
Conflict of Interest No conflict of interest
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