Patient And phaRmacist Telephonic Encounters (PARTE) in an Underserved Rural Patient Population with Asthma: Results of a Pilot Study

Abstract

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.

Healthcare Engagement and Encounters in a Rural State: A Focus Group Study

“…7,28-30 31 In remote areas, technology such as internet support groups, telehealth communication, and teaching models on disease states have been effective tools for improving health literacy, medication adherence, patient engagement and patient empowerment, especially for women. 7,12,23 Our study showed use of internet by respondents for preventative care and some future interest in using telehealth solutions for healthcare. For many rural areas, telehealth has been a great bridging opportunity to improve access and patient care.…”

“…22 Details about patient-centric issues were gleaned from the participants using a focus group protocol based on the existing literature, to guide the focus group discussions. 4,7,18,23 The focus group sessions were held in a neutral location -either at the University or the hospital conference room. Demographic information was also collected from each participant.…”

“…1 Rural populations suffer more from decompensated chronic diseases such as diabetes, asthma, hypertension, cardiovascular disease, and obesity than urban populations. [2][3][4][5][6][7] People in rural areas experience more barriers to quality health care including lack of access to primary care, specialty care, lower socioeconomics, and a greater likelihood of being underinsured or uninsured. Rural residents are also less likely to use preventive screening, and less likely to participate in self-care and engage in their health, leading to nonadherence to medication.…”

Rural Patients' Access to Mobile Phones and Willingness to Receive Mobile Phone-Based Pharmacy and Other Health Technology Services: A Pilot Study

“…6 Other investigators evaluated the telephonic patient-pharmacist encounters that provided information on inhaler use technique and selfmanagement to underserved rural asthma patients. 7,8 These studies showed the need to further demonstrate the role and value of telephonic pharmacist-patient interactions in resolving access barriers and improving patient care delivery. 7,8 M-health services like text messaging can promote safe medication use by improving the knowledge of pharmacists and patients, pharmacist-patient interaction, and pharmaceutical care.…”

“…7,8 These studies showed the need to further demonstrate the role and value of telephonic pharmacist-patient interactions in resolving access barriers and improving patient care delivery. 7,8 M-health services like text messaging can promote safe medication use by improving the knowledge of pharmacists and patients, pharmacist-patient interaction, and pharmaceutical care. 7 Whether or not the value of m-health services has been proven, a growing segment of the U.S. population is becoming accustomed to certain mhealth services and, perhaps, beginning to expect such services.…”