Australian pharmacy asthma programme succeeds
Ian Hooton/Science Photo Library
Asthma control was improved, although spirometry measures did not
change |
An asthma care plan based on national guidelines and delivered by community pharmacists in Australia has proved successful.
The Pharmacy Asthma Care Program was implemented in three states and
involved 50 pharmacies that were randomised to an intervention or a control
group. Over six months the intervention group provided an ongoing cycle
of assessment, management and review in collaboration with GPs. It included
targeted counselling and education about the condition, medication and
lifestyle, inhaler technique review, adherence assessment, goal setting
and review, and GP referral. The control group received no intervention
other than the pharmacists’ usual care.
The proportion of patients in the intervention group who were classified
as having severe asthma declined from 87.9 per cent to 52.7 per cent
(P<0.001) during the study, while that in the control group
remained unchanged (71.2 per cent to 67.9 per cent; P=0.11).
The researchers calculated that intervention patients were 2.7 times
more likely to improve from “severe” to “not
severe” than those in the control group (odds ratio 2.68, 95 per
cent confidence interval 1.64–4.37; P<0.001). The intervention
also resulted in improved adherence to preventer medicine (OR 1.89, 1.08–3.30;
P=0.03), a decrease in the mean daily dose of reliever medicine
(mean difference in change from baseline -149.11mg, -283.87– -14.36; P=0.03),
improvements in quality of life (difference -0.23, -0.46–0.00;
P=0.05), asthma knowledge (difference 1.18, 0.73–1.63; P<0.01)
and perceived control of asthma questionnaires (difference -1.39, -2.44– -0.35;
P<0.01). No significant change in spirometry measures were
observed in either group.
The study was published in Thorax Online First on 24 January 2007.
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