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A Targeted Approach to Improve Asthma Control Using Community Pharmacists.

Sarah Serhal1,2, Bandana Saini1,2, Sinthia Bosnic-Anticevich1,3

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Summary
This summary is machine-generated.

A new Pharmacy Asthma Service (PAS) improved quality of life for asthma patients but showed no significant difference in asthma control compared to usual care. This suggests current usual care standards may be higher than previously documented.

Keywords:
asthmaasthma controlcommunity pharmacyhealth servicesimplementationpharmacy services

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Area of Science:

  • Pharmacy Practice
  • Respiratory Medicine
  • Health Services Research

Background:

  • Developed a technology-supported Pharmacy Asthma Service (PAS) based on evidence-based community pharmacy asthma management.
  • Aimed to integrate the PAS into routine pharmacy practice for improved asthma management.
  • Built upon lessons learned from previous community pharmacy asthma management models.

Purpose of the Study:

  • To investigate the efficacy of the Pharmacy Asthma Service (PAS) in enhancing asthma symptom control.
  • To evaluate the impact of the PAS on other patient health outcomes.
  • To compare the PAS intervention against usual care in a pragmatic trial setting.

Main Methods:

  • A two-arm pragmatic cluster randomized controlled trial involving 95 pharmacies across three Australian States.
  • Participants included adults with poorly controlled asthma (using Asthma Control Questionnaire - ACQ) and potentially allergic rhinitis.
  • The PAS arm involved four pharmacist consultations over 12 months, guided by an algorithm and software addressing medication use, adherence, inhaler technique, and allergic rhinitis.

Main Results:

  • Both PAS and comparator (usual care) arms showed improvements in asthma control (ACQ scores).
  • No statistically significant difference in asthma control was found between the PAS and comparator arms (p=0.19).
  • Patients in the PAS arm experienced a significant improvement in quality of life (IAQLQ scores) compared to the comparator arm (p=0.0079).

Conclusions:

  • The pharmacist-led PAS significantly improved patients' quality of life but yielded comparable asthma control to usual care.
  • The findings suggest that current usual asthma care in community pharmacies may have evolved beyond previously reported standards.
  • Further reflection on and potential updates to usual care guidelines for asthma management are warranted.