Feasibility and Effectiveness of an Evidence-Based Asthma Service in Australian Community Pharmacies: A Pragmatic Cluster Randomized Trial. (April 2013)

• Record Type: Journal Article
• Authors: Armour, Carol L.; Reddel, Helen K.; Lemay, Kate S.; Saini, Bandana; Smith, Lorraine D.; Bosnic-Anticevich, Sinthia Z.; Song, Yun Ju Christine; Alles, M. Chehani; Burton, Deborah L.; Emmerton, Lynne; Stewart, Kay; Krass, Ines
• Is Part Of: Journal of asthma. Volume 50:Number 3(2013)
• Page Start: 302
• Page End: 309
• Publication Date: 2013-04
• Subjects: Asthma -- Periodicals; 616.238005
• DOI: 10.3109/02770903.2012.754463
• Languages: English
• ISSNs: 0277-0903

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <p> <italic>Objective</italic>. To test the feasibility, effectiveness, and sustainability of a pharmacy asthma service in primary care. <italic>Methods</italic>. A pragmatic cluster randomized trial in community pharmacies in four Australian states/territories in 2009. Specially trained pharmacists were randomized to deliver an asthma service in two groups, providing three versus four consultations over 6 months. People with poorly controlled asthma or no recent asthma review were included. Follow-up for 12 months after service completion occurred in 30% of randomly selected completing patients. Outcomes included change in asthma control (poor and fair/good) and Asthma Control Questionnaire (ACQ) score, inhaler technique, quality of life, perceived control, adherence, asthma knowledge, and asthma action plan ownership. <italic>Results</italic>. Ninety-six pharmacists enrolled 570 patients, with 398 (70%) completing. Asthma control significantly improved with both the three- and four-visit service, with no significant difference between groups (good/fair control 29% and 21% at baseline, 61% and 59% at end, <italic>p</italic> = .791). Significant improvements were also evident in the ACQ (mean change 0.56), inhaler technique (17–33% correct baseline, 57–72% end), asthma action plan ownership (19% baseline, 56% end), quality of life, adherence, perceived control, and asthma knowledge, with no significant difference between groups for any variable. Outcomes were sustained at 12 months post-service. <italic>Conclusions</italic>. The pharmacy asthma service delivered clinically important improvements in both a three-visit and four-visit service. Pharmacists were able to recruit and deliver the service with minimal intervention, suggesting it is practical to implement in practice. The three-visit service would be feasible and effective to implement, with a review at 12 months.</p> </abstract>