Bereznicki, BJ and Peterson, G and Jackson, S and Walters, EH and George, J and Stewart, K and March, GJ, Uptake and effectiveness of a community pharmacy intervention programme to improve asthma management, Journal of Clinical Pharmacy and Therapeutics,, 38, (3) pp. 212-218. ISSN 1365-2710 (2013) [Refereed Article]
Copyright 2013 Blackwell Publishing Ltd
What is known and Objective: Pharmacists frequently see patients with asthma in the community who have suboptimal management. This study aimed to compare the uptake and effectiveness of pharmacist-initiated mailed and face-to-face interventions for patients whose asthma may not be well managed.
Methods: Seventy-one community pharmacies in South Australia, Tasmania and Victoria (Australia) installed a software application that data-mined dispensing records, generating a list of patients who had received six or more asthma reliever inhalers in the preceding 12 months. The pharmacists were randomized, by pharmacy, to perform either a mailed or face-to-face intervention, whereby these patients received educational material and a referral to their general practitioner (GP) for an asthma management review. Matching patients from each pharmacy were also randomly assigned to a control group for ‘usual care’.
Results and Discussion: A total of 1483 patients were identified and grouped as follows: 510 (34.4%) mailed intervention, 480 (32.4%) face-to-face intervention and 493 (33.2%) controls. Significantly fewer face-to-face interventions were offered than mailed interventions (66.6% vs. 89.4%, respectively; χ2 = 64.2, P < 0.0001). There were significant improvements in the preventer-to-reliever ratio after the intervention period (P < 0.0001) in each group. In a per-protocol analysis, the magnitude of improvement in the face-to-face intervention group was greater than in the mailed intervention group. The reverse was true in an intention-to-treat analysis. The improvement in the P : R ratios was mainly due to significant decreases in reliever usage.
What is new and Conclusion: Community pharmacy dispensing records can effectively identify patients with suboptimal asthma management, who can then be referred to their GP for review. Time constraints in busy pharmacies may limit the uptake and effectiveness of face-to-face interventions in the ‘real world’ setting, making mailed interventions an attractive option.
|Item Type:||Refereed Article|
|Keywords:||asthma, medication, patient counselling, pharmacists, pharmacy, prescription records|
|Research Division:||Biomedical and Clinical Sciences|
|Research Group:||Pharmacology and pharmaceutical sciences|
|Research Field:||Clinical pharmacology and therapeutics|
|Objective Group:||Public health (excl. specific population health)|
|Objective Field:||Preventive medicine|
|UTAS Author:||Bereznicki, BJ (Dr Bonnie Bereznicki)|
|UTAS Author:||Peterson, G (Professor Gregory Peterson)|
|UTAS Author:||Jackson, S (Dr Shane Jackson)|
|UTAS Author:||Walters, EH (Professor Haydn Walters)|
|Web of Science® Times Cited:||21|
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