Study protocol for a feasibility trial in community pharmacy of a personalised behaviour change intervention to reduce reliever reliance and overuse in individuals with asthma.

Abstract

BackgroundIn patients with asthma, over-reliance and overuse of short-acting beta2 agonist (SABA) is common and associated with increased morbidity and mortality. Patient beliefs are a key driver of inappropriate reliever use. A recently developed, brief, online intervention has been shown to identify and shift patient beliefs that drive inappropriate reliever use. Whether this intervention works to shift beliefs in individuals with asthma when delivered by community pharmacists is unknown. ObjectiveTo investigate the feasibility and acceptability of a brief community pharmacist-delivered behavior change intervention, and its effect on beliefs about SABA and SABA use in patients with asthma. MethodsThis is a non-randomised, before- and after- study of 120 individuals aged 18 years and older, prescribed a SABA for their asthma symptoms, presenting to one of two enrolled community pharmacies in Auckland, New Zealand. At enrolment, all participants will complete the SABA Reliance Questionnaire (SRQ), Asthma Control Test and 5-item Medication Adherence Report Scale via an online survey platform. Control participants will receive usual asthma care from their community pharmacy. Intervention participants will receive the intervention to shift any misplaced beliefs about SABA, comprising the SRQ to identify individual beliefs about SABA, then personalized information and discussion between pharmacist and patient based on the specific responses to the questionnaires. Those on SABA monotherapy and/or are at risk of SABA overuse will be referred to the general practitioner. Effect on beliefs about SABA and actual SABA use will be assessed by the SRQ and dispensing records, respectively. Feasibility will be evaluated through participant recruitment and retention rates, intervention fidelity, appropriateness and procedures of outcome measures pre- and post-intervention, and acceptability by obtaining feedback from participants (both patients and pharmacists) on the intervention.

Evaluating the Feasibility of a Community Pharmacy-Delivered Behaviour Change Intervention to Reduce Reliever Reliance in Asthma

“…The full protocol has been previously reported. 16 This was a non-randomised, before-and after-feasibility study of individuals with asthma attending community pharmacies in Auckland, New Zealand. Individuals presenting to one of the four enrolled community pharmacies were eligible to participate in the study if they were aged 18 years or over and prescribed a SABA as a "reliever" for their asthma symptoms.…”

“…Participants in the intervention phase were provided with their score from the SRQ directly on their personal device after they had completed the questionnaire. The score ranged between 5 and 25 and based on this, participants were told they were either low (≤10), medium (11)(12)(13)(14)(15)(16)(17) or high (≥18) risk of relying on their reliever inhalers. Based on their personalised score, participants were also provided with information on their personal device about what their score might mean for their asthma.…”