Adherence enhancement for patients with asthma in community pharmacy practice: tools development and pharmacists’ feedback

Abstract

Objectives To develop tools for identifying and addressing medication adherence barriers so that they are asthma‐specific, to assess pharmacists’ perspectives on the use of the tools and their implementation in the community pharmacy practice. Methods Development of asthma adherence tools involved analysis of available tools that focused on identifying and resolving asthma‐specific barriers to adherence, followed by selection and modification of tools. Semi‐structured interviews were conducted with practicing community pharmacists on pharmacists’ experiences in addressing adherence for patients with asthma, barriers, special concerns and perceptions regarding the proposed tools and their implementation in practice. Audio‐recorded interviews were transcribed. Thematic analysis was conducted to describe pharmacists’ feedback. Key findings Three asthma‐specific tools, which were adapted from the Adherence Starts with Knowledge‐12 adherence tool and the Drug Adherence Work‐up tool, were utilized in this study, including: (1) a patient questionnaire to identify asthma medication adherence barriers, (2) a pharmacist ‘Conversation Starter’ document to efficiently facilitate identification and resolution of barrier(s), and (3) a patient pamphlet entitled ‘Breathe Easier’ to address and educate patients regarding identified barrier(s). Pharmacists’ (N = 5) overall perspectives on the approach and proposed tools were positive. All pharmacists acknowledged high patient need for asthma education and adherence support. Most of the interviewees agreed that common adherence barriers were addressed in the tools and that the main barrier regarding program implementation was time. Providing focused counselling by utilizing tools that identify specific patient issues and offer possible solutions may help overcome the time barrier. Conclusions The proposed tools can enhance patient–pharmacist communication and have the potential to improve adherence and overall asthma management, which can lead to a decreased asthma burden.

Examination of Barriers to Medication Adherence, Asthma Management, and Control Among Community Pharmacy Patients With Asthma

“…31 Quite often patients may be confident regarding correct inhaler use, but it may not hold true when their techniques are observed. 17,32…”

“…Detailed information regarding the tool has been described elsewhere. 17 The following components of data were collected via patient survey: 1) demographic characteristics and comorbidities (5 items); (2) the Asthma Control Test (ACT) (5 items); (3) the aforementioned ASK-12 tool with 3 additional items pertaining to possession of the asthma action plan (AAP)/knowing the goals of therapy, knowledge on how to use an inhaler correctly, and symptom-based use of controller inhalers (14 items; Figure 1); and (4) asthma management characteristics (7 items). Demographic characteristics included age, race, gender, and education.…”

“…As part of a larger study, we conducted a pilot study to better understand the feasibility of using an asthma-specific tool in community pharmacy settings. 17 Qualitative interviews with community pharmacists revealed that the tool was user-friendly and conducive to counseling and that it captured common asthma barriers. The goal of this study was to describe common barriers to asthma medication adherence barriers and examine associations between patient-reported adherence barriers and (1) asthma control, and (2) asthma management characteristics.…”

Qualitative Investigation of Community Pharmacy Immunization Enhancement Program Implementation

“…Lack of time is something that is and has been commonly mentioned when non-prescription-focused pharmaceutical services are mentioned. [33][34][35][36] The 2014 US National Workforce Survey found that 47% of independent and 80% of chain pharmacists stated their workload was high or excessively high, and 49% and 76%, respectively, also reported that their workload had increased or greatly increased compared with the previous year. The report additionally noted that independent and chain pharmacists spent on average 14% and 11%, respectively, of their time on business and management activities, with 23% and 32% of respondents stating that the percent of time spent on these activities had increased compared with the previous year.…”

Improving Asthma Management: Patient–Pharmacist Partnership Program in Enhancing Therapy Adherence

“…Two tools were developed during an earlier phase of this project: an "Asthma Conversation Starter" booklet for pharmacists and a "Breathe Easier" pamphlet for patients [27]. Based on the Drug Adherence Work-up (DRAW) tool, the "Asthma Conversation Starter" provides pharmacists with guidance on how to discuss and resolve adherence-related issues [28].…”