Chronic obstructive pulmonary disease (COPD) includes persistent pulmonary inflammation resulting in parenchymal tissue destruction and disrupted repair and defense mechanisms, and leads to air flow limitation, air trapping, and breathlessness.1 Approximately 15 million adults in the United States report that they have been diagnosed; however, the actual number of adults with COPD is believed to be much higher because an estimated 12 million adults remain undiagnosed with the disease.2,3 As the third leading cause of death in the country, COPD represents a significant burden.4 In 2010, it resulted in $29.5 billion in direct healthcare expenditures.5 In 2008, there were more than 820,000 hospitalizations for COPD among adults aged 40 years and older.6
To address this burden, on October 1, 2014, the Centers for Medicare & Medicaid Services included COPD in its Hospital Readmissions Reductions Program. This inclusion resulted in reduced Medicare reimbursement for hospitals that demonstrate excessive 30-day COPD patient readmission rates.
Implementation of a multidisciplinary approach to patient care and focused attention on transitions of care from admission through discharge and outpatient follow-up is essential for successful management of care. Pharmacists hold a unique position in the patient care continuum. They serve a number of roles including being a patient point of contact, a care coordinator with physicians, and an interface with the formulary manager. Moreover, pharmacists hold important roles in patient follow-up and adherence to medication. Appropriate treatment algorithms, medication, and training are all within the purview of pharmacists and can improve COPD readmissions.