Pharmacist Intervention Improves Asthma Outcomes

Author: Jeannette Y. Wick, RPh, MBA, FASCP

Asthma patients who received tailored counseling from community pharmacists over a 6-month period were 3 times as likely as those in a control group to have their asthma under control.

Asthma patients who receive individualized counseling from their pharmacists experience significantly improved outcomes, according to the results of a study carried out by researchers at the Academic Center in Pharmaceutical Care, University of Granada, Spain, and published online on June 27, 2013, in Respiratory Medicine.
 
The researchers enrolled 336 adult asthmatics in a 6-month cluster randomized controlled trial, assigning 186 participants to intervention at a community pharmacy and 150 participants to a control group. All participants had a prescription for Symbicort (budesonide/formoterol) and were at least 18 years old. Those in the intervention group received tailored counseling from trained pharmacists during 3 pharmacy visits addressing their individual asthma control concerns, inhaler technique, and level of medication adherence. Pharmacists providing care to those in the intervention group educated participants using verbal instructions, physical demonstration, and written information. A critical element for success was joint goal setting at each visit. Patients in the control group received usual care during pharmacy visits.
 
Outcomes were gauged using the 5-item Asthma Control Questionnaire (ACQ), a 10-step turbuhaler checklist, the 4-item Morisky-Green-Levine Adherence Scale, and pharmacist observations. The results indicated that patients in the intervention arm were 3 times as likely to have their asthma under control at 6 months as those in the control arm, although positive changes were evident as early as 3 months into the study. In the intervention group, mean ACQ scores improved significantly, and the number of controlled asthma patients increased by 30.1%. Medication adherence also improved from 38.2% at baseline to 78.5% at 6 months in the intervention group. Adherence levels improved in the control group as well, but by a smaller magnitude: from 39.3% at baseline to 52% at 6 months.
 
The researchers noted that pharmacists who provided care to those in the intervention arm seemed to have no trouble incorporating it into their daily practices, but added that more study is needed to determine whether community pharmacists could routinely provide such care.

Ms. Wick is a visiting professor at the University of Connecticut School of Pharmacy and a freelance writer from Virginia.