Role of Pharmacists in Asthma Adherence

One of the most common diseases in the developed world is asthma. According to the CDC, 1 in 13 people have asthma. Yet, adherence to inhaled preventive asthma medication is suboptimal in more than 50% of people. More than 300 million people have asthma, and that number is expected to grow rapidly by an additional 100 million by 2025. As the most accessible healthcare professional, pharmacists have a duty to help people administer their preventer inhaler regularly, as prescribed.

Pharmacist-led interventions can increase medication adherence, and reduce its economic burden on healthcare. In a systematic review and meta-analysis recently published in the European Respiratory Journal, researchers show how effective pharmacist-led interventions are in medication adherence.

Researchers looked at 20 studies that met their inclusion criteria, including looking at only participants with asthma and no other respiratory conditions. Researchers measured adherence by focusing on:

• Electronic adherence monitoring devices (Doser, Smartinhaler)
• Pharmacy based data (prescription refill rates)
• Patient self reported measures, and
• Reports from healthcare professionals or caregivers.

Interestingly, researchers categorized the interventions based on pharmacist involvement. This categorization differentiates between telling patients that they should use their inhaler daily, and specifically targeting patients’ concerns with their inhalers.

Interventions were further categorized as non-PAPA (targeting only perceptions or practicalities), partial PAPA (targeting perceptions and practicalities), or full PAPA (tailored approach targeting perceptions and practicalities).

Of the 20 studies, 6 found a significant intervention effect on medication adherence. It’s important to note that the interventions included in this review were from all over the world, which may affect their findings. The findings from this review are in line with recent reviews targeting adherence to inhaled corticosteroids.

Pharmacists can fill the general practitioner gap, serving as medication experts by informing patients about the importance of sticking to their asthma medications, and addressing their concerns.

Mohammad Waleed, is a 2019 PharmD Candidate at the University of Connecticut.

Reference

Mes MA, Katzer CB, Chan AHY, et al. Pharmacists and medication adherence in asthma: a systematic review and meta-analysis. Eur Respir J 2018; in press (https://doi.org/10.1183/13993003.00485-2018).