5 ways pharmacists can help patients breathe easier with COPD

In this article:

• What is COPD?
• Helping patients with COPD
• The bottom line

In this article

• What is COPD?
• Helping patients with COPD
• The bottom line

Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death worldwide. It affects 11.7 million adults and is the cause of hundreds of thousands of emergency room (ER) visits each year, according to the American Lung Association. Pharmacists are in a unique position to help patients manage their COPD. From helping patients adhere to their treatment plan to recommending appropriate lifestyle modifications, pharmacists play an important role in helping patients manage their COPD. 

What is COPD?

COPD is a chronic lung disease characterized by air flow limitation. This can lead to less oxygen being delivered to the organs. It is considered a progressive disease, meaning it gets worse over time. But the earlier someone receives a diagnosis of COPD, the sooner treatment can begin. This can help preserve lung function. The most common symptoms of COPD include: 

• Chronic cough
• Shortness of breath
• Wheezing or chest tightness
• Fatigue or tiredness
• Coughing up phlegm
• Trouble breathing
• Difficulty taking a deep breath

Because there is no cure for COPD, treatment is focused on managing symptoms and decreasing exacerbations. Healthcare providers categorize COPD into one of four stages: mild, moderate, severe, or very severe. Treatment depends on which stage of COPD a patient has. 

Several types of medications are used to manage COPD, including: 

• Short-acting and long-acting bronchodilators
• Antimuscarinic drugs
• Methylxanthines
• Combination bronchodilator medications
• Inhaled and oral corticosteroids
• Phosphodiesterase-4 (PDE-4) inhibitors
• Antibiotics
• Mucolytics
• Antioxidant agents

How to help patients with COPD

Pharmacists can educate patients on several aspects of COPD management. In fact, there is evidence that pharmacist-led COPD interventions can positively influence COPD by reducing hospital and ER visits, helping patients quit smoking, and improving inhaler techniques. Here are five ways pharmacists can help patients manage their COPD. 

1. Educate patients on proper inhaler use

As medication experts, pharmacists can help educate patients about the proper use of their medications—whether that means reviewing dosage and administration instructions, side effects, or potential drug interactions. Inhalers in particular can be tricky to use, especially for patients who are newly diagnosed with COPD. Pharmacists can help counsel patients on how and when to use their inhaler, as well as provide any other important administration instructions. For example, explain how short-acting beta agonists should be used as needed for acute symptoms only, while long-acting beta agonists should be used daily for long-term control. 

It is also helpful to have patients open the device during the counseling session so you can show them exactly how to administer a dose. Remind them to refer to the instructions that come with the device if they have any questions. 

2. Encourage medication adherence

Nonadherence to COPD medications has been linked to increased morbidity and mortality, more frequent exacerbations, and higher healthcare costs. Pharmacists have an invaluable opportunity to encourage medication adherence, which can help improve outcomes. One way to do this is through patient counseling. 

Research has shown that medication adherence in COPD is low due to gaps in understanding, forgetfulness of the patient, lack of provider availability, financial burden, and substance use. When patients come into the pharmacy to pick up their medications, pharmacists can take the opportunity to explain the importance of adherence in preventing exacerbations and hospitalizations. You can also provide strategies to remember to take their medications, such as setting daily reminders or pairing their medication with another daily activity. Lastly, offering different options for financial support, including using a SingleCare coupon or applying for patient assistance, can be extremely helpful for patients who are struggling with the costs of treatment. 

3. Offer appropriate vaccines

People with lung disease are at higher risk of serious illness from respiratory diseases, such as the flu, COVID-19, pneumonia, and respiratory syncytial virus (RSV). Due to this, the Centers for Disease Control and Prevention (CDC) recommends the following vaccines in people with COPD to help prevent illness:

• COVID-19
• Flu
• Pneumococcal

Pharmacists play a key role in improving vaccination rates among COPD patients by identifying patients who are eligible for the vaccine and educating them about the importance of getting vaccinated. All three of the recommended vaccines are typically available in retail pharmacy settings as well.  

4. Identify exacerbations that warrant medical care

As frontline healthcare providers, pharmacists may be among the first to notice if a patient is experiencing or has experienced a COPD exacerbation. Signs and symptoms of a COPD flare may include:

• Trouble catching your breath or taking a deep breath
• Coughing or wheezing more than usual
• Producing more phlegm than normal
• Difficulty sleeping 
• Gray or pale skin
• Blue or purple lips or nails
• Trouble speaking in full sentences
• Increased use of a rescue inhaler

Recognizing these signs and providing timely referrals can help reduce the risk of complications and hospitalizations. 

5. Recommend lifestyle modifications

Certain lifestyle changes can help COPD patients feel better, stay more active, and slow the progression of their disease, according to the National Institutes of Health (NIH).

Diet, for example, plays a role in managing COPD symptoms. Encouraging patients to eat smaller meals throughout the day, rest before eating, and consume a healthy diet with fresh fruits and vegetables, whole grains, and fish can help protect their lungs. 

Physical activity can also help strengthen breathing muscles and improve overall wellness. 

Smoking cessation is essential for people with COPD as it has a major influence on the disease course. Several states have passed legislation that allows community pharmacists to provide smoking cessation counseling and smoking cessation drug therapy. There is also evidence that pharmacist-led smoking cessation counseling has been linked to long periods of abstinence, according to a study published in the American Journal of Health-System Pharmacy. 

The bottom line

Management of COPD consists of reducing symptoms and preventing exacerbations. As frontline healthcare providers and medication experts, pharmacists can help patients accomplish this in several ways. These include educating patients on proper medication use, encouraging medication adherence, offering appropriate vaccinations, identifying patients who need medical care, and recommending lifestyle modifications.