The research of the Pharmaceutical Care Unit is organised in 4 lines of research about rational pharmacotherapy:

1. Patients with chronic conditions
2. Self-treatment with OTC-medication
3. Specific patient populations
4. Pharmacoepidemiology

1. Patients with chronic conditions

This line of research consists of clinical studies carried out in the community pharmacy with respect to the role of the pharmacist in the treatment of chronic conditions. These studies are always oriented towards one specific affliction (e.g. asthma, COPD, diabetes) and can be observational or interventional. The observational studies have the aim of charting the present treatment of a particular pathology and to identify the obstacles. Afterwards recommendations are formulated to improve the pharmaceutical care. The effectiveness of this pharmaceutical care intervention is then evaluated by a randomised, controlled trial. In this way the content of pharmaceutical care for a particular affliction can be elaborated in a rational way.

Below you can find some studies already carried out and the corresponding publications:

Asthma

• E. Mehuys, L. Van Bortel, L. Annemans, J.P. Remon, I. Van Tongelen, E. Van Ganse, L. Laforest, G. Chamba and G. Brusselle (2006). Medication use and disease control of asthmatic patients in Flanders: a cross-sectional community pharmacy study. Respir Med, 100: 1407-14.
• E. Mehuys, L. Van Bortel, L. De Bolle, I. Van Tongelen, L. Annemans, J.P. Remon and G. Brusselle (2008). Effectiveness of pharmacist intervention for asthma control improvement. Eur Respir J, 31: 790-799.

COPD

• E. Mehuys, K. Boussery, E. Adriaens, L. Van Bortel, L. De Bolle, I. Van Tongelen, J.P. Remon and G. Brusselle (2010). COPD management in primary care: an observational, community pharmacy-based study. Ann Pharmacother, 44: 257-266.
• Tommelein E, Mehuys E, Van Hees T, Adriaens E, Van Bortel L, Christiaens T, Van Tongelen I, Remon JP, Boussery K, Brusselle G. Effectiveness Of PHARMAceutical Care For Patients with COPD (PHARMACOP): a Randomized Controlled Trial. Br J Clin Pharmacol (2014), 77(5): 756-77.

2. Self-treatment with OTC-medication

Self-medication of upper GI symptoms

• E. Mehuys, L. Van Bortel, L. De Bolle, I. Van Tongelen, J.P. Remon and D. De Looze (2009). Self-medication of upper gastrointestinal symptoms: a community pharmacy study. Ann Pharmacother, 43: 890-898.

Self-medication of headache

• E. Mehuys, K. Paemeleire, T. Van Hees, T. Christiaens, L. Van Bortel, I. Van Tongelen, L. De Bolle, J.P. Remon and K. Boussery. Self-medication of regular headache: a community pharmacy-based survey. Eur J Neurol (2012), 19(8):1093-9.

Self-medication of rhinitis

• E. Mehuys, P. Gevaert, G. Brusselle, T. Van Hees, E. Adriaens, T. Christiaens, L. Van Bortel, I. Van Tongelen, L. De Bolle, J.P. Remon and K. Boussery. Self-medication in persistent rhinitis: overuse of decongestants in half of the patients. J Allergy Clin Immunol Pract (2014), 2(3): 313-9.

3. Specific patient populations

A. Older patients

Many older patients take multiple medicines at the same time. This polypharmacy can, however, cause problems, which may lead to hospitalisation. Several international studies showed that 5 to 20% of hospitalisations are drug-related, and about half of these are considered preventable.

Prevention and early detection of drug-related problems in older patients is of increasing importance. Community pharmacists may be ideally placed to engage in this process because of their medication-specific knowledge and because of the availability of an electronic dispensing record in the pharmacy. However, this engagement would require an evidence-based and feasible screening tool specifically suitable for use in the typical community pharmacy practice (ie, no access to patients' clinical data). Such a tool, to the best of our knowledge, has not yet been developed. Therefore, a multidisciplinary team of Ghent University has developed the GheOP³S-tool: the Ghent Older People’s Prescriptions community Pharmacy Screening tool.

More information on the GheOP³S tool

B. Medication adherence in type 2 diabetes patients of Turkish decent (doctoral project by Bart Peeters)

The prevalence of type 2 diabetes among Turkish immigrants in Belgium is two to three times higher than among the native population. At present, no investigation has been carried out on the factors that influence therapy adherence and more particularly medication adherence in this group. This doctoral research (2008-2012) wants to fill the gap by charting the factors that hinder or encourage therapy adherence. In addition, care providers (family doctors and pharmacists) have been questioned about their experiences and about the possibilities for a further optimalisation of the care for these patients. On the basis of these results an intervention will ultimately be developed for the improvement of medication adherence.

PhD thesis Bart Peeters:

Adherence to oral hypoglycaemic agents among type-2 diabetes patients of Turkish descent (pdf)

C.  Drug administration in institutions for mentally disabled persons (doctoral project by Elke Joos)

Institutions for mentally disabled persons are often confronted with very specific problems in drug administration, e.g. when medication has to be administered by means of an enteral feeding tube. The aim of this doctoral project (2010-2014) is to study this problem area thoroughly, to set up instructions that can be used in actual practice, and to investigate how a (clinical) pharmacist can contribute to the quality of the care for this group of vulnerable patients.

PhD thesis Elke Joos:

Medication in residential care facilities for individuals with intellectual disability: focus on administration through enteral feeding tube (pdf)

4. Pharmacoepidemiology

This research line combines clinical pharmacology with epidemiology to promote rational drug use in the society. The impact of drugs on public health is evaluated in terms of use, (cost)effectiveness and safety. Focused areas are therapy adherence, personalized medicine, and multimorbidity. Evidence therefrom supports the quality of pharmaceutical care.

Below you can find some examples of studies within this research line:

Personalized medicine:

• Lahousse L, Loth DW, Joos GF, Hofman A, Leufkens HG, Brusselle GG, Stricker BH. Statins, systemic inflammation and risk of death in COPD: the Rotterdam Study. Pulm Pharmacol Ther. 2013 Apr;26(2):212-7.
• de Roos EW, In 't Veen JC, Braunstahl GJ, Lahousse L, Brusselle GG. Targeted Therapy for Older Patients with Uncontrolled Severe Asthma: Current and Future Prospects. Drugs& Aging. 2016 Sep;33(9):619-28.
• Andreas S, Janson C, van den Berge M, Lahousse L. Cardiac impact of inhaled therapy in the largest randomised placebo-controlled trial in COPD history: have we reached the SUMMIT? ERJ Open Res. 2016 May 26;2(2).

Side effects:

• Lahousse L, Verhamme KM, Stricker BH, Brusselle GG. Cardiac effects of current treatments of chronic obstructive pulmonary disease. Lancet Respir Med. 2016 Feb;4(2):149-64.
• Loth DW, Brusselle GG, Lahousse L, Hofman A, Leufkens HG, Stricker BH. Beta-blockers and pulmonary function in the general population: the Rotterdam Study. Br J Clin Pharmacol. 2014 Jan; 77(1): 190–200.