"A New Chapter in Respiratory Disease Management: How the CMO Model ""Empowers, Builds Confidence, and Creates Opportunities"" for Patients"

Breathing is the most basic rhythm of life. However, for the hundreds of millions of respiratory disease patients worldwide, every smooth breath can be a luxury. From common asthma and COPD to rare pulmonary hypertension and cystic fibrosis, these diseases not only seriously affect the quality of life but are also the third leading cause of death globally. In the past three decades, due to factors such as environmental pollution, their prevalence has surged by nearly 40%.

Although new drugs are constantly emerging, the treatment effects are often unsatisfactory. What is the problem? Studies have found that many patients encounter huge obstacles in the "medication" link: about half of the patients fail to use their inhalers on time, and less than one-third of the patients can operate the inhalers correctly. This dilemma of "knowing is easy, doing is hard" leads to recurrent illness, frequent hospitalizations, and even an increased risk of death. The traditional medical model often only focuses on "what medicine is prescribed," but ignores "how the patient uses the medicine," "why the patient uses the medicine," and "whether the patient can adhere to the medicine."

To solve this problem, a group of hospital pharmacy experts from Spain recently published a study in the journal Frontiers in Pharmacology , proposing and preliminarily validating a new hospital pharmacy service model called "CMO," which aims to fundamentally change the management of respiratory diseases.

Key Findings: What is the CMO Model?

The CMO model is not a new drug or a new device, but a patient-centered comprehensive management strategy. It consists of three core pillars: Capacity, Motivation, and Opportunity, aiming to comprehensively improve patients' self-management level and treatment effects.

1. Capacity: Precise Stratification, Personalized Care

The traditional "one-size-fits-all" service model can no longer meet the complex and diverse needs of patients. The first step of the CMO model is to create a "precise portrait" of the patient. The research team developed an assessment tool containing 22 variables, covering demographic characteristics (such as age, pregnancy), clinical conditions (such as comorbidities, disease severity), treatment-related factors (such as medication adherence, use of complex drugs), and socioeconomic status.

Through this tool, pharmacists can act like "health detectives," identifying the core problems faced by different patients and dividing them into three priority levels:

• High priority: The most complex patients, who may have multiple diseases, use multiple drugs, have poor adherence, etc., and require the closest attention and intervention.
• Medium priority: Patients with moderate conditions.
• Low priority: Patients with relatively stable conditions and strong self-management skills.

This stratified management, like creating a customized "health file" for each patient, allows limited medical resources to be "used where they are most needed," providing the highest intensity of support for the patients who need it most.

2. Motivation: Inspiring Motivation, Shared Decision-Making

There is a huge gap between "the doctor told me to do this" and "I want to do this." The CMO model emphasizes that the key to bridging this gap is to stimulate the patient's intrinsic motivation.

The model introduces the psychological tool of "Motivational Interviewing." In communication with patients, the pharmacist is no longer a one-way commander but a listener and a guide. They help patients to explore their willingness to change, understand the value of treatment, and jointly set achievable treatment goals. For example, the pharmacist might ask, "What do you think will be the biggest improvement in your life after you stick to using the inhaler?" In this way, the treatment goals are linked to the patient's personal wishes (such as "being able to walk with my grandson easily"), thus transforming "I have to be treated" into "I want to be treated."

3. Opportunity: Making Good Use of Technology, Creating Convenience

In today's fast-paced society, frequent hospital follow-ups are a burden for many patients with chronic diseases. The CMO model actively embraces information and communication technologies (ICTs), especially telemedicine.

Through tools such as video calls and mobile apps, pharmacists can provide remote pharmaceutical care services to patients. This not only breaks down geographical restrictions, allowing patients to receive professional medication guidance and follow-up at home, but also enables continuous health monitoring. For example, the pharmacist can remotely observe the patient's inhaler technique and correct it, or promptly answer the patient's questions about drug side effects. This creates more "opportunities" for patients to interact with professionals and receive support.

Research Methods and Limitations

This study was led by an expert panel of 15 hospital pharmacists. They first identified the 8 major respiratory diseases covered by the model through a literature review and expert consensus, and then developed the three pillars of the CMO model mentioned above. Subsequently, the research team conducted a preliminary test on 201- outpatient patients in 6 hospitals in Spain.

The results showed that the newly developed patient stratification tool was feasible and could effectively classify patients according to their complexity and needs. This provides preliminary evidence for the practicality of the model.

However, the researchers also admitted that this was only a preliminary validation study and had some limitations. First, the sample size was small and was only conducted within the Spanish healthcare system. Second, the study has not yet evaluated the final impact of the model on patient clinical outcomes (such as hospitalization rates, quality of life). Therefore, the conclusions should still be interpreted with caution.

Application Prospects and Summary

Although still in its early stages, the CMO model paints an exciting blueprint for the management of chronic respiratory diseases. It marks a major shift in medical services from "disease-centered" to "person-centered." By systematically assessing patients' "capacity," stimulating their "motivation," and creating convenient "opportunities," the model is expected to solve the long-standing problem of medication adherence that has plagued both doctors and patients.

In the future, the research team plans to validate the CMO model in a wider population and in different healthcare systems, and to evaluate its long-term clinical and economic benefits. If proven effective, this innovative model, which originated from pharmacy practice, may be extended to the management of more chronic diseases, ultimately allowing countless patients to better coexist with their diseases and regain the right to breathe freely.