Impact of educational intervention by community pharmacists on asthma clinical outcomes, quality of life and medication adherence: A systematic review and meta‐analysis

Abstract

What is known and objective: Community pharmacists can play an important role in controlling chronic diseases. This study aimed to evaluate the effects of pharmacists' educational interventions in the community pharmacy settings on asthma control and severity, quality of life (QOL) and medication adherence. Methods: Databases PubMed, Scopus and Web of Science were searched for evidence regarding asthma severity and control, QOL, and medication adherence after pharmacists' interventions in community pharmacy settings. Twenty-one studies were eligible for qualitative and quantitative analysis. Indices and questionnaires were used in the studies, such as Asthma-related quality of life (IAQLQ), Asthma Control Test (ACT), Perceived Control of Asthma Questionnaire (PCAQ), inhaler technique (IT), Asthma Control Questionnaire (ACQ), 36-Item Short Form survey (SF-36) and peak expiratory flow rate (PEFR). The outcomes were extracted, pooled and analysed as percentages, means, standard deviations and errors, and 95% confidence intervals (CIs).Results and discussion: Community pharmacists in all studies educated and followed up the asthmatic patients, addressing the outcome measures. Pharmacists underwent training courses of at least a day. Standardized mean differences for the indices were pooled as follows: IAQLQ −0.241 (95% CI, −0.362 to −0.121), ACT 0.14 (95% CI, 0.02 to 0.27), PCAQ −0.15 (95% CI, −0.28 to 0.01), IT 0.79 (95% CI, 0.05 to 1.54), ACQ −0.50 (95% CI, −0.69 to −0.30), SF-36 0.39 (95% CI, 0.16 to 0.62), PEFR 0.13 (95% CI, 0.01 to 0.26) and asthma symptoms score −0.34 (95% CI, −0.49 to −0.18). What is new and conclusion: Pharmacists' educational interventions in communitypharmacy settings could significantly improve asthma severity and control, QOL and medication adherence.

Impact of pharmaceutical care for asthma patients on health‐related outcomes: An umbrella review

“…Additionally, 199 were excluded after applying the inclusion and exclusion criteria on title and abstract. A total of 18 potentially relevant reviews were retrieved in full‐text: nine of them were excluded (The reasons for exclusion are provided in Supplementary File S1 ) and nine met the inclusion criteria 7 , 8 , 14 , 15 , 16 , 17 , 18 , 19 , 20 (Figure 1 ).…”

“…Of the nine reviews, only one was rated as high quality, 16 two as low quality 14 , 15 and six as critically low quality. 7 , 8 , 17 , 18 , 19 , 20 …”

“…The interventions consisted mostly of patient education programs, 7 , 8 , 14 , 15 , 16 , 18 , 20 support for asthma self‐management, 7 , 17 , 18 improving inhaler technique, 14 , 16 , 18 , 20 review of pharmacotherapy, 7 , 14 , 19 detection and resolution of medication‐related problems, 7 and early referral to the primary care physician or specialist. 7 , 18 …”

“…There are also systematic reviews and meta‐analyses (MA) published in recent years that suggest that pharmacists' interventions have a positive impact on asthma control, severity and symptoms, and medication adherence. 7 , 8 Nevertheless, the role of clinical pharmacists is poorly represented, most of the patients included present mild‐to‐moderate asthma, and with the commercialization of the monoclonal antibodies, the treatment has become much more complex. The Cochrane Collaboration recommends an overview of systematic reviews to summarize the evidence of existing systematic reviews that address different outcomes for a single intervention.…”

Seguimento farmacoterapêutico de uma coorte aleatória para monitoramento de pacientes com asma em tratamento bem definido utilizando um aplicativo móvel de autogerenciamento

“…Da mesma forma, apenas três (25%) dos doze AM que ofereciam orientação sobre a técnica inalatória adequada eram consistentes com as diretrizes(HUCKVALE et al, 2015).Baseado nesses dados verifica-se a necessidade do envolvimento da equipe de saúde na avaliação dos escores e dados utilizados por esses AM, visando o monitoramento e autogerenciamento dos sintomas de pacientes com asma, incluindo profissionais de saúde não-médicos, como os farmacêuticos, que podem contribuir nessa avaliação.De acordo com a Organização Pan-americana de Saúde (1993), os farmacêuticos têm um papel fundamental a exercer no que se refere a atender as necessidades dos indivíduos e da sociedade, com o objetivo de assegurar uma (DADER; MUÑOZ;MARTÍNEZ-MARTÍNEZ, 2008). Dessa forma, programas de educação e monitoramento de pacientes com asma realizados por profissionais farmacêuticos têm grande potencial no controle da doença e na qualidade de vida, melhorando a adesão ao tratamento e a utilização dos medicamentos inalatórios(MAHDAVI;ESMAILY, 2021;SANTOS et al, 2010).A partir dessa revisão, considerando a necessidade de avaliação de AM direcionados a pessoas com asma, propõe-se um seguimento farmacoterapêutico de…”