Abstract

To assess the impact of a nationally coordinated pharmacy-based educational intervention on self-management behaviour and markers of asthma control in self-referred patients with asthma. An asthma clinic day was set up by a national chain of community pharmacies whereby pharmacists used a structured questionnaire to assess asthma control and self-care among self-referred patients with doctor-diagnosed asthma. In a one-on-one counselling session, each patient's educational needs were identified and the appropriate education offered. A telephone follow-up 30 days later assessed the impact of teaching. Community pharmacies across Canada. The follow-up questionnaire quantified the number of wheezing episodes or other symptoms per week, the number of night-time awakenings per week, and the frequency of use of reliever and preventive medications. Of 4080 patients assessed, 22.2% used an inadequate inhaler technique, 16.4% used a short acting beta2-agonist excessively and 21.0% were not using an inhaled corticosteroid daily despite a frequency of symptoms that would suggest that it was needed. Common educational interventions included a review of inhaler technique (41.9%), a recommendation for regular inhaled corticosteroids (31.5%) and a referral to the primary care physician (21.0%). Thirty days after the educational intervention, patients reported significant decreases in the frequency of daytime asthma symptoms, the frequency of nocturnal symptoms and the frequency with which short acting beta2-agonists were used, while reporting significant increases in their use of preventive medication. A brief assessment and an educational intervention in the community pharmacy can produce significant short term improvements in patient-reported symptom control and appropriate self-management behaviour.

Highlights

  • Common educational interventions included a review of inhaler technique (41.9%), a recommendation for regular inhaled corticosteroids (31.5%) and a referral to the primary care physician (21.0%)

  • Changes in proportions of asthma symptoms, and frequency of use of reliever and preventive medications, before and after the intervention were compared using the c 2 test, with results considered significant at the P

  • Figure 1) Proportion of patients who had sought urgent asthma care once, twice, more than twice or not at all in the preceding year more frequently than three times weekly by 16.4% of patients; inhaled steroids were not being used regularly by 21.0% of patients with symptoms of poorly controlled asthma; and 18.0% of patients had one or more manifestation of suboptimal asthma control beyond frequent beta2-agonist use

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Summary

OBJECTIVE

To assess the impact of a nationally coordinated pharmacy-based educational intervention on selfmanagement behaviour and markers of asthma control in self-referred patients with asthma. DESIGN: An asthma clinic day was set up by a national chain of community pharmacies whereby pharmacists used a structured questionnaire to assess asthma control and selfcare among self-referred patients with doctor-diagnosed asthma. In a one-on-one counselling session, each patient’s educational needs were identified and the appropriate education offered. A telephone follow-up 30 days later assessed the impact of teaching. OUTCOME MEASURES: The follow-up questionnaire quantified the number of wheezing episodes or other symptoms per week, the number of night-time awakenings per week, and the frequency of use of reliever and preventive medications

RESULTS
DISCUSSION
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