OBJECTIVE To evaluate the effectiveness of a clinical pharmacist-led medication reconciliation(MR) service on chronic disease management in patients with pneumoconiosis complicated with chronic obstructive pulmonary disease(COPD).

METHODS A prospective randomized controlled trial was conducted. A total of 200 patients with pneumoconiosis complicated with COPD were randomly allocated to intervention group(n=100) and control group(n=100). All enrolled patients received routine examinations and treatment, while those in the intervention group additionally received medication reconciliation services implemented by clinical pharmacists. The pulmonary function indicatorspercentage of predicted forced expiratory volume in first second(FEV₁%) and six minutes walk distance (6MWD), clinical symptom scores (CAT and mMRC scores), medication adherence scores, the proportion of patients with poor adherence, 3-month readmission rate after discharge, incidence of adverse drug reactions(ADRs), and hospitalization-related economic indicators were compared between the 2 groups at 1 month and 3 months after discharge.

RESULTS During follow-up, 5(5.00%) and 8(8.00%) patients were lost in the intervention and control groups, respectively. In the intervention group, 51 patients(51.00%) had at least one medication discrepancy. At 3 months post-discharge, FEV₁% and 6MWD in the intervention group were significantly improved compared with baseline(P<0.05) and notably higher than those in the control group(P<0.05). The CAT and mMRC scores in the intervention group were significantly reduced at both 1 and 3 months post-discharge compared to admission levels(P<0.05) and were significantly lower than those in the control group at the corresponding time points(P<0.05). The readmission rate and incidence of ADRs during follow-up were significantly lower in the intervention group than in the control group(P<0.05). Medication adherence scores in the intervention group at 1 month and 3 months post-discharge were significantly higher compared with baseline and the concurrent control group(P<0.05), and the proportion of patients with poor adherence decreased more markedly than in the control group(P<0.05). Furthermore, there were statistically significant differences between the two groups in indicators including total hospitalization costs, medication costs and drug-to-cost ratio during treatment(P<0.05).

CONCLUSION Clinical pharmacist-led MR service can effectively reduce medication discrepancies, significantly improve lung function and symptom control, enhance medication adherence, and lower the risks of readmission and ADRs in patients with pneumoconiosis complicated with COPD. It provides an effective strategy to guarantee patients’ medication safety and reduces the economic burden on the healthcare system.