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Eur Respir J 2007, doi:10.1183/09031936.00112007
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ORIGINAL ARTICLE |
Effectiveness of a pharmacist intervention for asthma control improvement
1 Pharmaceutical Care Unit Ghent, Faculty of Pharmaceutical Sciences, Ghent University, Harelbekestraat 72, 9000 Ghent, Belgium
2 Heymans Institute of Pharmacology, Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185, 9000 Ghent, Belgium
3 Dept of Public Health, Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185, 9000 Ghent, Belgium
4 Dept of Respiratory Diseases, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium
* To whom correspondence should be addressed. E-mail: els.mehuys{at}ugent.be.
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Abstract |
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Education on optimal medication use is an essential strategy to improve asthma control. We investigated whether a pharmacist intervention, focused on appropriate use of asthma medication and tailor-made to the patient's current asthma control, would improve asthma control in adult patients.
We conducted a 6-month randomised controlled parallel-group trial in 66 community pharmacies in Belgium. Patients were randomly assigned to receive usual pharmacist care (n=94) or a predefined pharmacist intervention (n=107). This intervention mainly focused on improving inhalation technique and medication adherence. Primary outcome was the level of asthma control, assessed by the Asthma Control Test® (ACT).
Mean ACT scores did not change from baseline for both study groups. However, a predefined subgroup analysis of patients having insufficiently controlled asthma at baseline showed that the intervention had significantly increased the ACT score after 6 months compared with usual care (p=0.038). The intervention also reduced, for the complete study group, reliever medication use (p=0.012) and the frequency of night-time awakenings due to asthma (p=0.044). Inhalation technique (p=0.004) and adherence to controller medication were significantly better in the intervention group (p=0.016).
Pragmatic community pharmacy-based programs can significantly improve therapeutic outcomes in adult asthma patients. (ClinicalTrials.gov, NCT00263159.)
Keywords: Adherence, asthma, asthma education, inhalation technique, pharmacotherapy
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