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COPD patients to be monitored in their homes as part of EU pilot

Clinical Pharmacists of 12 patients will assess inhaler technique and offer medicine advice and smoking cessation remotely in a trial next year

Community pharmacists in the UK will be monitoring and treating COPD patients in their homes as part of a European-wide telehealth project.

The pharmacists of 12 patients will be monitoring inhaler technique and offering medicine advice and smoking cessation in a trial next year, as part of project aimed at improving the overall care of those with COPD.

Pharmacists will be trialing an attachable inhaler  device that monitors how the patient is using their inhaler in their own home, said pharmacist and Kingston University lecturer Shereen Nabhani-Gebara, who has been involved in running the project along with academics in five European countries.

Pharmacists will be trialing an attachable inhaler adherence device that monitors how the patient is using their inhaler in their own home

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The device records and sends the information electronically via a secure technological "cloud-based medical hub" that pharmacists can access, she told C+D last week (March 25). 

The information is displayed as graphs to show patients' performance and adherence on a biweekly or monthly basis, and pharmacists can use it to counsel the patient or communicate with the prescriber to make changes accordingly, she said.

The inhaler device had been designed as part of the £4 million (6m euro) Welcome project that involved the development of a range of equipment to help monitor patients in their homes via telehealth.

The four-year project, funded by the European Union's Seventh Framework Programme for Research and Development, was in its first year and had so far conducted meetings with COPD patients in Greece, Germany, Netherlands, UK and Ireland, Ms Nabhani-Gebara said.

COPD patients received "fragmented" care because they were seeing a range of health professionals for their co-morbidities, she said. Pharmacists were "out of the loop" despite pharmacists being crucial to improving inhaler technique and medicines adherence.

Ms Nabhani-Gebara has been conducting the research with a team at Kingston University including associate dean for research and enterprise Barbara Pierscionek, lecturer Nada Philip, and clinical pharmacy lecturer Reem Kayyali.

"The novelty is pharmacists [being] involved in this research, as we tend to be out of the loop when it comes to big research projects in healthcare. We are pushing for the role of pharmacists because we know how much community pharmacists can contribute," she said.

Twelve patients from each country would trial the inhaler device with their pharmacist over three months starting at the end of 2015, Ms Nabhani-Gebara said.

"That's when COPD patients really catch viruses and infections. That's when they will most need it," she said. "After that, we will see how acceptable it was, how we need to tweak it or fix it."

The Welcome project was also designing a vest embedded with sensors to pick up lung sounds so healthcare professionals could catch exacerbations early and tell patients if they needed to take antibiotics or steroids, she added.

In 2007, the World Health Organisation estimated that COPD would be the fourth largest cause of global mortality by 2030. Health professionals were under increasing pressure to deliver integrated care and optimise quality of life for COPD patients, the project leaders said.

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