A Targeted Approach to Improve Asthma Control Using Community Pharmacists

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.