Impact of an asthma-specific questionnaire on problem identification and clinical and economic outcomes in ambulatory patients with persistent asthma

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ObjectiveTo determine the impact of an asthma-specific questionnaire on problem identification and patient outcomes. DesignProspective, two-group, parallel, randomized, multisite study. SettingConducted at 10 community pharmacies in suburban Detroit from January 2000 to April 2003. Patients60 adult and pediatric patients with persistent asthma receiving daily medication. InterventionA 17-item questionnaire designed to query understanding of and response to therapy and confidence in asthma prevention and treatment was completed by all participants at routine visits. Pharmacists reviewed questionnaire results with 31 intervention (group 1) participants during a 5- to 10-minute interaction, while 29 control (group 2) participants received standard care only. Main outcome measuresNumber and type of problems identified. Secondary outcomes were use of clinical outcomes, resource utilization, drug use and understanding, missed school or work days, and participant confidence. ResultsGroup 1 and group 2 participants were monitored for a mean of 5.4 and 5.2 months, respectively. Overall, 68 problems were identified in group 1 and 4 in group 2. Confidence in preventing asthma episodes improved 29% and confidence in treating symptomatic episodes improved 10% in group 1 participants, whereas there were no improvements in group 2. Symptom frequency, rescue drug use, restricted activity, and patients with more than two nocturnal episodes per month decreased within both groups. There were low incidences of and no statistically significant group differences for frequency of oral steroids, resource use, and missed school or work days. Likewise, group differences in drug use and understanding were not significant. ConclusionThe questionnaire aided pharmacists in problem identification and may be useful in a busy pharmacy. Study limitations such as small sample size, short follow-up period, and liberal enrollment contributed to the lack of group differences in our secondary outcomes. Future studies need to address our study limitations and explore additional practical methods of providing pharmaceutical care in the community pharmacy setting.