The College of Pharmacy discussed the MSc thesis entitled “Assessing the Impact of Social Determinants of Health on Clinical Outcome of Patients with Chronic Obstructive Pulmonary Disease in Iraq: A Mixed Method Study” by the student Sami Yusur Mashlool and the supervisor, Assistant Professor Dr .Ali Lateef Jasim, at the Clinical Pharmacy Department.
The study aimed to explore the perspectives of respiratory physicians regarding the impact of social determinants of health on the clinical outcomes of a sample of patients with chronic obstructive pulmonary disease in Baghdad, Iraq. Sought to assess the effect of these determinants on symptom severity and lung function tests, as well as to analyze their relationship with patients’ interleukin-6 levels.
The study included a parallel mixed-methods design, combining qualitative and quantitative approaches. The qualitative phase involved conducting semi-structured interviews with board-certified respiratory physicians in Baghdad Medical City to explore their perspectives on the impact of social determinants of health on clinical outcomes. The quantitative phase included adult patients with chronic obstructive pulmonary disease from Baghdad Teaching Hospital, with the collection of relevant clinical and laboratory data, which were statistically analyzed to examine the relationship between social determinants of health, symptom severity, lung function tests, and inflammatory marker levels, thereby enhancing the comprehensiveness and accuracy of the findings.
The study concluded that air pollution and persistent financial difficulties were the most significant factors affecting poor outcomes in chronic obstructive pulmonary disease, followed by difficulty accessing healthcare and poor housing conditions. Additionally, the lowest FEV1 values and highest serum IL-6 levels were observed in patients experiencing housing instability (p = 0.002 and 0.003, respectively), low social support (p = 0.001 and 0.002, respectively), high air pollution (p = 0.004 for both), difficulty accessing healthcare (p < 0.002 and p = 0.002, respectively), and low monthly income (p = 0.03 and 0.01, respectively).
The study recommended conducting future research in multiple hospitals and provinces using longitudinal designs to monitor changes in patients’ experiences, disease progression, and treatment outcomes over time, complementing cross-sectional data. Also, It suggested increasing sample sizes by recruiting more patients to enhance the statistical power of findings, establishing a national center within hospitals to record social determinants of health linked directly to the Ministry, and creating specialized respiratory units in peripheral areas to ensure easy access to diagnosis, treatment, and prevention, reduce pressure on central hospitals, and improve follow-up of chronic obstructive pulmonary disease cases. Furthermore, the study emphasized launching national awareness campaigns about COPD and the harms of smoking, e-cigarettes, and shisha, highlighting the pivotal role of pharmacists in patient education and supporting smoking cessation.
