Evaluation of a Community Pharmacist Managed Asthma Consultation Service

Abstract

Background: Asthma is one of the most common chronic health conditions, affecting 900,000 Ontarians and 2.4 million Canadians. Research evidence indicates that pharmacists can play a critical role in the management of asthma yet there is a paucity of studies which focus on community-based pharmacist asthma interventions on adults in Ontario, Canada. Purpose: The aim of this study is to evaluate an asthma-specific pharmacist-led intervention over a 12-month period in relation to patient health outcomes and patient satisfaction. Methods: This prospective cluster randomized controlled study required trained intervention pharmacists to identify asthma patients, deliver medication reviews and educate patients in order to improve asthma measures. The validated measures selected for the study were adherence to medication, asthma knowledge and peak expiratory flow rate. 12 pharmacies in and around Toronto, Ontario were recruited. Results: A total of 81 patients were identified by pharmacists as potential participants over the course of the program. Of these, 19 consented to participate and 14 completed the program. The intervention group saw a statistically significant improvement of asthma knowledge scores (p=0.02). In both groups, all patients had improved medical adherence scores after completion of the program. Diurnal variation between control and intervention groups was found to be significantly different. Control patients had significantly more days of high variability than the intervention group. Conclusion: The implementation of a pharmacist-provided comprehensive education program in a community pharmacy setting had a positive impact on patients’ diurnal variation, asthma related knowledge and adherence to medication. While the target sample size was not achieved and results cannot be generalized, this study is an important step towards understanding the benefits of a pharmacist-delivered intervention in asthma management.