Objective: To assess the feasibility, acceptability, and preliminary impact of a telepharmacy intervention in an underserved, rural asthma patient population. Subjects and Methods: Patients with asthma were randomized to receive either standard care or telephone consultations from pharmacists regarding asthma self-management over a 3-month period. Qualitative interviews were conducted to identify participants' attitudes/ opinions regarding the intervention. Baseline and follow-up surveys assessed asthma control, patient activation, and medication utilization. Results: Ninety-eight adults were recruited (78% accrual); 83 completed the study (15% dropout). Participants reported positive opinions and believed the intervention improved their asthma self-management. The intervention group had significantly higher patient activation compared with the control (p < 0.05). There were no significant between-group differences regarding asthma control. However, within-group analyses of the intervention group showed an improvement in asthma control (p < 0.01) and medication adherence (p < 0.01). No within-group differences were found for the control group. Conclusions: This telepharmacy intervention is feasible and showed indicators of effectiveness, suggesting the design is well suited for a robust study to evaluate its impact in uncontrolled asthma patients. Pharmacists helping patients manage asthma through telecommunications may resolve access barriers and improve care.

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During the past several years, the emphasis on quality in health care has been evolving. Alongside this evolution of change has been the advancement of clinical pharmacy services in ambulatory care settings. Although they share importance, both health care quality and ambulatory clinical pharmacy services have progressed and moved in their own directions. Nevertheless, in today's evolving health care landscape, collaboration among providers, including pharmacists, must occur to enhance quality. Pharmacy services must improve quality to be a sustainable health care service. This White Paper provides a rationale and structure that unite health care quality and ambulatory clinical pharmacy services. By applying national principles of quality measurement, this paper proposes five tenets to consider when developing measures for clinical pharmacy services in the ambulatory care setting: comprehensive, accountable, scientifically sound, feasible, and usable. Definitions of each tenet are presented. This paper uses exemplary literature on ambulatory clinical pharmacy services including diabetes mellitus, dyslipidemia, chronic lung disease, hypertension, anticoagulation, and heart failure to provide a context for the tenets and a discussion of their use. This paper also describes issues pertaining to health care quality and related costs using similar exemplary literature. Finally, a discussion is presented on both the opportunities and the challenges of measuring quality for ambulatory clinical pharmacy services. Issues related to the tenets, including shared accountability for health care quality, availability of comprehensive data to assess quality outcomes, feasibility of collecting and reporting quality, and the need for additional rigorous scientific evaluation of ambulatory clinical pharmacy services, are described.