Development, implementation, and evaluation of a community pharmacy-based asthma care model.
BACKGROUND
Pharmacists are uniquely placed in the healthcare system to address critical issues in asthma management in the community. Various programs have shown the benefits of a pharmacist-led asthma care program; however, no such programs have previously been evaluated in Australia.


OBJECTIVE
To measure the impact of a specialized asthma service provided through community pharmacies in terms of objective patient clinical, humanistic, and economic outcomes.


METHODS
A parallel controlled design, where 52 intervention patients and 50 control patients with asthma were recruited in 2 distinct locations, was used. In the intervention area, pharmacists were trained and delivered an asthma care model, with 3 follow-up visits over 6 months. This model was evaluated based on clinical, humanistic, and economic outcomes compared between and within groups.


RESULTS
There was a significant reduction in asthma severity in the intervention group, 2.6 +/- 0.5 to 1.6 +/- 0.7 (mean +/- SD; p < 0.001) versus the control group, 2.3 +/- 0.7 to 2.4 +/- 0.5. In the intervention group, peak flow indices improved from 82.7% +/- 8.2% at baseline to 87.4% +/- 8.9% (p < 0.001) at the final visit, and there was a significant reduction in the defined daily dose of albuterol used by patients, from 374.8 +/- 314.8 microg at baseline to 198.4 +/- 196.9 microg at the final visit (p < 0.015). There was also a statistically significant improvement in perceived control of asthma and asthma-related knowledge scores in the intervention group compared with the control group between baseline and the final visit. Annual savings of $132.84(AU) in medication costs per patient and $100,801.20 for the whole group, based on overall severity reduction, were demonstrated.


CONCLUSIONS
Based on the results of this study, it appears that a specialized asthma care model offers community pharmacists an opportunity to contribute toward improving asthma management in the Australian community.
Faculty of Pharmacy, University of Sydney, Sydney, Australia. bandana@pharm.usyd.edu.au
Bandana
B
Saini
Ines
I
Krass
Carol
C
Armour
D000328:Adult; D000420:Albuterol / Q000191:economics / Q000627:therapeutic use*; D001249:Asthma / Q000145:classification / Q000188:drug therapy*; D001315:Australia; D001993:Bronchodilator Agents / Q000191:economics / Q000627:therapeutic use*; D016022:Case-Control Studies; D003157:Community Pharmacy Services / Q000458:organization & administration*; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011788:Quality of Life; D012720:Severity of Illness Index
D001993:Bronchodilator Agents; D000420:Albuterol