[A cross-sectional study on the self-management status of asthma patients under different follow-up and medication...

Objective: To investigate the asthma control and self-management status of asthma patients under different healthcare-seeking models, as well as the differences in patient education provided by community pharmacists and hospital-based physicians. Methods: This study is a cross-sectional study. A total of 661 asthma patients (94 from pharmacies and 567 from respiratory departments of hospitals) and 208 healthcare professionals (106 pharmacy pharmacists and 102 hospital physicians engaged in respiratory diagnosis and treatment) were recruited from pharmacies and respiratory departments of hospitals in Shanghai City and Jiangsu Province, China, for a self-designed questionnaire survey from October 2023 to October 2024. Statistical analysis of the data was conducted using methods such as the chi-square test. Results: The results of this study showed that the median age of patients receiving medication dispensing in pharmacies was lower than that of patients receiving follow-up medication dispensing in hospitals (36 years vs. 40 years, Z=-3.015, P<0.01). Additionally, the asthma course of pharmacy-dispensed patients was shorter, with only 5.3% of patients having a disease duration longer than 3 years (5.3% vs.36.9%, χ²=36.640, P<0.001), they had fewer comorbidities (17.0% vs. 38.6%, χ²=16.423, P<0.001), lower annual household income, with 80.0% of patients having an annual household income of 100 000 yuan or less (80.0% vs.44.4%, χ²=30.664, P<0.001), higher employment rate (84.0% vs. 59.8%, χ²=20.403, P<0.001), and lower educational level, with only 19.1% of patients having a bachelor's degree or above (19.1% vs.51.3%, χ²=33.529, P<0.001). In terms of disease management, the rates of regular hospital follow-up (36.2% vs. 68.7%, χ²=96.618, P<0.001), regular pulmonary function re-examination (40.4% vs. 57.1%, χ²=21.727, P=0.001), and allergen screening (9.6% vs. 43.9%, χ²=39.959, P<0.001) among pharmacy-dispensed asthma patients were all lower than those of hospital patients. In terms of asthma disease education, the mastery rate of most disease-related knowledge among pharmacy-dispensed patients was lower than that of hospital follow-up patients (Except for "being able to accurately describe asthma and its treatment methods", P<0.001). Among the participating pharmacists in pharmacies, the proportion of mid-to-senior professional titles (6.6% vs. 86.3%) and the proportion of pharmacists with more than 10 years of practice (44.3% vs. 86.3%, χ²=38.924, P=0.006) were both lower than those in hospitals. Regarding the implementation of asthma health education, pharmacy pharmacists were inferior to hospital doctors in aspects such as having full-time personnel for asthma health education (20.8% vs. 56.9%, χ²=27.428, P<0.001), dedicated places (16.0% vs. 63.7%, χ²=47.460, P<0.001), and regularly holding educational activities (19.8% vs. 82.4%, χ²=78.400, P<0.001). Conclusions: Asthma patients receiving medication dispensing from pharmacies, compared with those under hospital follow-up, are characterized by a younger age, shorter disease duration, fewer comorbidities, lower household annual income, higher employment rate, and lower educational level. Their adherence to regular follow-up, management of acute attack risks, and level of asthma-related knowledge are all lower than those of patients under hospital follow-up. Meanwhile, there are significant differences between pharmacies and hospitals in terms of the objective conditions for health education and the implementation level of patient education.