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 results in symptoms such as shortness of breath, chronic coughing, mucus production, and fatigue. COPD often includes both chronic bronchitis and pulmonary emphysema. While the disease is not curable, medications delivered via inhalers, smoking cessation, and proper support can relieve symptoms and improve quality of life. Correct use of inhalation medication is essential for this.
COPD patients who receive intensive guidance from a hospital pharmacist during their stay use their inhalation medication more correctly and with greater confidence. This was shown in a study conducted by Annelies I.M. Walravens and Emma Walravens (Medicine and Pharmacology, Vrije Universiteit Brussel), in collaboration with colleagues from, among others, the Queen Elisabeth Institute in Oostduinkerke. The study also demonstrated that the applied protocol is feasible in clinical practice and widely supported by healthcare professionals.
"Most studies start from a hypothesis, but our idea came directly from practice," says Annelies Walravens. "We saw that COPD patients often struggle with using their inhalers correctly. Our study showed that intensive, step-by-step guidance by a pharmacist can truly make a difference."
The research builds on earlier work by Prof. Eline Tommelein, who studied the impact of pharmaceutical counseling in community pharmacies. "In our study, we adapted that model to a hospital setting, specifically the Queen Elisabeth Institute, which specializes in pulmonary rehabilitation," explains Emma Walravens. "We followed each patient six times in total, spread over their hospital stay and the following weeks."
The study not only showed improvement in the use of inhalers but also revealed that patients felt more empowered. "For many patients, this was the first time they received such a thorough explanation about their medication," says Stephanie Wuyts (Research Center for Digital Medicine, VUB). "They greatly appreciated the personal attention, which clearly boosted their adherence to treatment."
Healthcare providers also supported the initiative. "In a focus group at the end of the process, doctors, nurses, IT staff, and other professionals acknowledged the added value of the protocol," says Sander Boudewyn (Queen Elisabeth Institute). "They viewed it as a realistic yet valuable addition to care."
The feasibility of this type of intervention is further strengthened by the support of auxiliary services. Kayleigh Spriet (Queen Elisabeth Institute) adds: "With good task distribution and IT support, the pharmacist can focus on where they truly make a difference: education and follow-up."
According to Dr. Kristel De Paepe, pulmonologist at the Queen Elisabeth Institute, the strength of the project lies in collaboration. "This study clearly shows that multidisciplinary work improves patient care. And that pharmacists can play a central role in that."
Prof. Eline Tommelein (VUB) concludes: "This research confirms that what began as a pilot project now forms a solid foundation for a structural approach within hospitals. The results provide tools to structurally improve medication adherence—and therefore the patient's quality of life."
Reference:
Walravens A, Walravens E, Wuyts S, et al. Inhalation innovation: optimizing COPD care through clinical pharmacist integration in a rehabilitation hospital's multidisciplinary team – a quality improvement study. Chronic Obstr Pulm Dis. 2025; 12(3): 240-249. doi: http://doi.org/10.15326/jcopdf.2024.0569
Contact:
Prof. Eline Tommelein: eline.tommelein@vub.be
Emma Walravens: emma.walravens@vub.be 0470253620
Annelies Walravens: annelies.ine.walravens@vub.be 0485003678