Clinical pharmacist-led intervention improves anxiety, depression and inhaler technique in budesonide/glycopyrronium/formoterol-using patients: A single-center prospective randomized cohort study

Background: Chronic respiratory disease (CRD) patients using budesonide/glycopyrronium/formoterol (BGF) inhalers often face anxiety, depression and incorrect inhaler technique, which impair treatment outcomes. Objectives: This study aimed to evaluate the effects of clinical pharmacist-led intervention on anxiety, depression, inhaler technique, adverse drug reactions (ADR) and body mass index (BMI) in BGF users. Methods: A prospective randomized cohort study enrolled 100 BGF users from July 2023 to December 2023 at a public tertiary hospital and randomized them 1:1 to either the experimental or control group. Among these, 48 experimental patients and 45 control patients completed this study, which comprised an initial and three follow-up visits. The control group received routine care, whereas the experimental group received supplementary care led by a clinical pharmacist alongside conventional treatment. Outcomes included Self-Rating Anxiety Scale (SAS), the Self-Rating Depression Scale (SDS), Inhaler technique scores, Adverse drug reaction (ADR) and Body mass index (BMI) were assessed at 1-, 3- and 6-months post-intervention. Results: The experimental group had lower SAS scores at 3/6 months (p<0.05), lower moderate-to-severe anxiety rate at 6 months (68.75% vs. 93.33%, p<0.05) and lower SDS scores at 3/6 months (p<0.05). Inhaler technique scores were higher in the experimental group at all follow-ups (p<0.05). ADR incidence was lower (2 vs. 5 cases) and BMI slightly increased (p=0.312). Conclusions: Pharmacist-led intervention alleviates anxiety/depression, improves inhaler technique and reduces ADR in BGF users. These findings support the adoption of pharmacist-led integration into comprehensive BGF management.