Can a self-management programme delivered by a community pharmacist improve asthma control? A randomised trial

Abstract

Background: No randomised studies have addressed whether self-management for asthma can be successfully delivered by community pharmacists. Most randomised trials of asthma self-management have recruited participants from secondary care; there is uncertainty regarding its effectiveness in primary care. A randomised controlled study was undertaken to determine whether a community pharmacist could improve asthma control using self-management advice for individuals recruited during attendance at a community pharmacy. Methods: Twenty four adults attending a community pharmacy in Tower Hamlets, east London for routine asthma medication were randomised into two groups: the intervention group received self-management advice from the pharmacist with weekly telephone follow up for 3 months and the control group received no input from the pharmacist. Participants self-completed the North of England asthma symptom scale at baseline and 3 months later. Results: The groups were well matched at baseline for demographic characteristics and mean (SD) symptom scores (26.3 (4.8) and 27.8 (3.7) in the intervention and control groups, respectively). Symptom scores improved in the intervention group and marginally worsened in the control group to 20.3 (4.2) and 28.1 (3.5), respectively (p,0.001; difference adjusted for baseline scores = 7.0 (95% CI 4.4 to 9.5). Conclusions: A self-management programme delivered by a community pharmacist can improve asthma control in individuals recruited at a community pharmacy. Further studies should attempt to confirm these findings using larger samples and a wider range of outcome measures.

Evaluation of Allergic Rhinitis and Asthma Control in a Portuguese Community Pharmacy Setting

“…[31][32][33] Briefly, in Portugal, the health system is public and universal, but the pharmacies are private with guaranteed universal access. As such, the community pharmacy is in an optimal place to medication and self-reported the pathology, we could not confirm that AR patients were not in fact ARA patients.…”

Effectiveness of pharmacist intervention for asthma control improvement

“…These factors have already been shown to be an important barrier to the achievement of good asthma control, as prescribing an appropriate asthma control treatment may not be successful when the patient uses the medication inappropriately [6][7][8][9]. Only a few well-designed studies have investigated the effect of pharmacist care on asthma patients to date [10][11][12][13][14][15]. These studies have shown improvements in peak flow [12][13][14][15], asthma severity [10,13], symptom scores [11], drug utilisation [10,[12][13][14] and humanistic outcomes (e.g.…”

“…Only a few well-designed studies have investigated the effect of pharmacist care on asthma patients to date [10][11][12][13][14][15]. These studies have shown improvements in peak flow [12][13][14][15], asthma severity [10,13], symptom scores [11], drug utilisation [10,[12][13][14] and humanistic outcomes (e.g. quality of life, asthma knowledge) [10,[12][13][14].…”

“…quality of life, asthma knowledge) [10,[12][13][14]. However, the pharmacist interventions described in these publications [10][11][12][13][14][15] were not tailored to the patients' current level of asthma control (as recommended by GINA 2006). The evaluated interventions also focused on several aspects of asthma management, as follows.…”

Community Pharmacist-Led New Medicine Service for Patients With a Long Term Medical Condition: A Cross-Sectional Study

“…Several studies involving community pharmacy-led asthma interventions have demonstrated a positive impact on patients' asthma-related quality of life and peak expiratory flow rates [26][27][28][29][30].…”