Pharmaceutical Care: Impact on Asthma Medication Use

Abstract

Background: Asthma has been recognised as a poorly managed disease state in Australia. Rural areas have been identified as being under‐serviced by health professionals. Pharmacists in rural areas are in a prime position to be involved in the provision of multidisciplinary asthma care. Aim: This study investigated the impact of spirometry screening on asthma management by pharmacists in rural areas. Method: A two‐group (intervention: n = 141, control: n = 46) multicentre study design was utilised. The control group was provided with a standard medication review while the intervention group received spirometry testing and a medication review. The study protocol required pharmacists to refer participants to a doctor if required, based on spirometry or medication review results. The researchers assessed asthma severity and adequacy of asthma medication. Results: Spirometry as an intervention attracted participants to the study pharmacies and provided an opportunity for pharmacists to screen and refer a group who may otherwise be overlooked. Medication review identified suboptimal therapy, potentially contraindicated drug combinations and adverse drug reactions. Conclusion: Spirometry adds benefit to the provision of pharmaceutical care for people with asthma. This may have additional significance in rural areas where access to other health services is limited.

The role of community pharmacists in screening and subsequent management of chronic respiratory diseases: a systematic review

“…Our preliminary search identified a number of articles on asthma studies, but several had to be excluded as they did not screen or assess patients7,31 although some of them claimed to be assessing/screening asthma control57, or was a follow-up study 56. The review also found that although all of the included studies suggested screening for poor asthma control, critical examination of the content revealed that seven of the fifteen studies were actually assessing asthma control in every one presenting to the pharmacy with a prior diagnosis of asthma and only eight of the studies involved screening.…”

An evaluation of a community pharmacy‐based rural asthma management service

“…Community pharmacy settings are effective sites for health promotion, screening and disease management services. Controlled studies have demonstrated the positive impact of pharmacist's involvement in asthma management in rural areas of Australia and New Zealand 6,7 . Globally, there is sufficient evidence to suggest that pharmacists can help improve outcomes in asthma patients 8–10 .…”

Pharmacist Provided Spirometry Services: A Scoping Review

“…Additionally, a group of studies conducted in Australia described and assessed implementation of spirometry services for the purposes of asthma management in the community pharmacy setting (n=5). 19 , 21 , 25 , 30 , 33 …”

“…18 , 23–25 , 29 , 30 Additionally, some studies describe other models, such as special booths, screening days or appointment-based models within the pharmacy 18 , 25 , 27 , 29 or community pharmacists participating in community health fairs or health screening events at corporate offices. 28 Several studies required that participating pharmacies have a private area where the pharmacist could meet with the patient to perform the test 20 , 24–26 , 30 (n=5) and that at least two pharmacists were on duty at all times (n=4). 19 , 20 , 25 , 29 Where it was not required, there was a trend of higher screening rates when a second pharmacist or an intern was on duty.…”

“…Most often patients were recruited for the spirometry service by convenience from customers entering the pharmacy, 28 , 31 though specific customers were typically targeted, usually because they were filling prescriptions for respiratory drugs, purchasing cough medications or smoking cessation products, or endorsed respiratory symptoms or smoking (n=12). 18–20 , 22–26 , 30 , 32 Patients were also recruited through advertisements in the newspaper and flyers or posters in the pharmacy. 18 , 22 , 28 , 30 …”