Literature Collection

PURPOSE: Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of morbidity and mortality worldwide, and suboptimal medication management contributes to exacerbations and preventable healthcare utilization. Pharmacist-led integrated care has the potential to improve medication use and clinical outcomes. We conducted a systematic review and meta-analysis to evaluate the effects of pharmacist-led interventions in COPD. METHODS: This systematic review and meta-analysis was conducted and reported in accordance with PRISMA 2020. We searched PubMed, Embase, and Web of Science from inception until June 23, 2025. Randomized controlled trials (RCTs) assessing the effects of pharmaceutical care on clinical outcomes in COPD patients were included. A random-effects model was used to estimate pooled relative risks (RRs) or mean differences (MDs) with 95% confidence intervals (CIs). Risk of bias was assessed using the Cochrane Risk of Bias tool. RESULTS: A total of 11 randomized controlled trials involving 2313 participants were included. Pharmacist-led interventions were associated with a lower risk of exacerbation-related hospital admissions (RR = 0.43, 95% CI: 0.33-0.55). Improvements in medication adherence and higher smoking cessation rates were also observed. Improvements in health-related quality of life were reported; however, substantial heterogeneity was present. In contrast, effects on COPD Assessment Test scores and objective disease measures, including lung function, were non-significant. Overall study quality was variable, with many trials being small and at high risk of bias. CONCLUSION: Pharmacist-led interventions in COPD may improve selected medication-related and patient-centered outcomes; however, the available evidence is heterogeneous and limited by study quality and inconsistent effects across outcomes. These findings should be interpreted cautiously, and well-designed, adequately powered trials with standardized outcomes are needed before robust conclusions regarding clinical effectiveness can be drawn.

BACKGROUND: Pharmacogenomics (PGx) is a well-established concept of how genes impact medication response, with many studies demonstrating reductions in medication side effects, improved efficacy and cost effectiveness. Despite these benefits, implementation of PGx in daily practice remains limited. Studies on the implementation of PGx in clinical practice have previously found that inadequate knowledge is one of the main barriers. Details regarding specifically which educational needs exist among family medicine clinicians requires further study. OBJECTIVE: The aim of this study was to identify both the perceived role that pharmacogenomics (PGx) could play in primary care practice, the knowledge gaps that family medicine clinicians experience, and the skills they require to use PGx in their daily practice. METHODS: To achieve this aim, the attitudes, knowledge, barriers, skills needed, and preferred educational program were explored in a family medicine clinician focus group study via a semi-structured interview and knowledge quiz. Second, multidisciplinary focus groups provided information on the level of knowledge and necessary skills to use PGx in patient care. After gathering key recorded information from both focus groups, the perceived role pharmacogenomics could possibly play in primary care, the predominant knowledge gaps, and the most appropriate educational program was determined by qualitative analysis. RESULTS: Four themes emerged regarding the PGx educational needs and the role of PGx in family medicine: 1) need for PGx competences, 2) insight into the roles and responsibilities of PGx services, 3) optimization of PGx workflow through artificial intelligence integrated in the electronic health record, and 4) the ethical dilemmas and psychological effects related to PGx. These themes reflect a shift in the role of PGx in family medicine with implications for education. CONCLUSION: The results obtained from this study will help improve the implementation of PGx in daily practice, and consequently, may result in increased utilization of PGx, thereby resulting in improved medication efficacy and reduced side effects.