Community pharmacy-based pharmaceutical care for asthma patients.
BACKGROUND
Despite significant progress in asthma drug therapy in recent years, there has been no major change in asthma morbidity and mortality. It is still important to determine whether pharmaceutical care (PC) influences health outcomes.


OBJECTIVE
To evaluate the effectiveness of PC with regard to clinical, humanistic, and economic outcomes in adults with asthma.


METHODS
An intervention study was conducted over 12 months. At baseline, 39 community/retail pharmacies, 84 primary care physicians (general practitioners, internal specialists, chest physicians), and 183 patients (aged 18-65 y) diagnosed with asthma were included. To evaluate economic outcomes, 2 German statutory health insurance funds provided 2 years of claims data for their insured patients (n = 55). A 1:10 matching was carried out to compare the data of this intervention subgroup with those of a control group (n = 550).


RESULTS
Significant improvements were found for all humanistic outcomes (eg, asthma-specific quality of life, self-efficacy, knowledge, medication adherence). In addition, asthma severity, self-reported symptoms, peak expiratory flow, and patients' inhalation technique improved. Increases in forced expiratory volume in 1 second and vital capacity were not significant over time. Evaluation of the insurance claims data revealed a shift toward better adherence to evidence-based therapy.


CONCLUSIONS
The study shows that PC for people with asthma has a positive impact on humanistic and, to some extent, on clinical outcomes. To determine potential economic benefits, future research should focus on patients with more severe asthma.
Mangiapane
Sandra
S
Center for Drug Information and Pharmacy Practice, ABDA-Federal Union of German Associations of Pharmacists, Berlin, Germany.
Schulz
Martin
M
Mühlig
Stephan
S
Ihle
Peter
P
Schubert
Ingrid
I
Waldmann
Hans-Christian
HC
D058672:Adrenergic beta-2 Receptor Antagonists; D000318:Adrenergic beta-Agonists / Q000627:therapeutic use; D000328:Adult; D018927:Anti-Asthmatic Agents / Q000145:classification / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy*; D003157:Community Pharmacy Services / Q000592:standards* / Q000706:statistics & numerical data / Q000639:trends; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007345:Insurance Claim Review / Q000191:economics / Q000706:statistics & numerical data; D008297:Male; D010366:Peak Expiratory Flow Rate / Q000187:drug effects; D010593:Pharmaceutical Services / Q000592:standards* / Q000639:trends; D011795:Surveys and Questionnaires; D013806:Theophylline / Q000627:therapeutic use; D013997:Time Factors; D016896:Treatment Outcome
D058672:Adrenergic beta-2 Receptor Antagonists; D000318:Adrenergic beta-Agonists; D018927:Anti-Asthmatic Agents; D013806:Theophylline