title: Pharmacy Asthma Care Program (PACP) improves outcomes for patients in the community.
abstract: BACKGROUND
  Despite national disease management plans, optimal asthma management remains a challenge in Australia. Community pharmacists are ideally placed to implement new strategies that aim to ensure asthma care meets current standards of best practice. The impact of the Pharmacy Asthma Care Program (PACP) on asthma control was assessed using a multi-site randomised intervention versus control repeated measures study design.
  
  
  METHODS
  Fifty Australian pharmacies were randomised into two groups: intervention pharmacies implemented the PACP (an ongoing cycle of assessment, goal setting, monitoring and review) to 191 patients over 6 months, while control pharmacies gave their usual care to 205 control patients. Both groups administered questionnaires and conducted spirometric testing at baseline and 6 months later. The main outcome measure was asthma severity/control status.
  
  
  RESULTS
  186 of 205 control patients (91%) and 165 of 191 intervention patients (86%) completed the study. The intervention resulted in improved asthma control: patients receiving the intervention were 2.7 times more likely to improve from "severe" to "not severe" than control patients (OR 2.68, 95% CI 1.64 to 4.37; p<0.001). The intervention also resulted in improved adherence to preventer medication (OR 1.89, 95% CI 1.08 to 3.30; p = 0.03), decreased mean daily dose of reliever medication (difference -149.11 microg, 95% CI -283.87 to -14.36; p=0.03), a shift in medication profile from reliever only to a combination of preventer, reliever with or without long-acting beta agonist (OR 3.80, 95% CI 1.40 to 10.32; p=0.01) and improved scores on risk of non-adherence (difference -0.44, 95% CI -0.69 to -0.18; p=0.04), quality of life (difference -0.23, 95% CI -0.46 to 0.00; p=0.05), asthma knowledge (difference 1.18, 95% CI 0.73 to 1.63; p<0.01) and perceived control of asthma questionnaires (difference -1.39, 95% CI -2.44 to -0.35; p<0.01). No significant change in spirometric measures occurred in either group.
  
  
  CONCLUSIONS
  A pharmacist-delivered asthma care programme based on national guidelines improves asthma control. The sustainability and implementation of the programme within the healthcare system remains to be investigated.
authors.affiliation: Faculty of Pharmacy, Pharmacy Building A15, The University of Sydney, NSW 2006, Australia. carola@pharm.usyd.edu.au
authors.forename: Carol
authors.initials: C
authors.lastname: Armour
authors.forename: Sinthia
authors.initials: S
authors.lastname: Bosnic-Anticevich
authors.forename: Martha
authors.initials: M
authors.lastname: Brillant
authors.forename: Debbie
authors.initials: D
authors.lastname: Burton
authors.forename: Lynne
authors.initials: L
authors.lastname: Emmerton
authors.forename: Ines
authors.initials: I
authors.lastname: Krass
authors.forename: Bandana
authors.initials: B
authors.lastname: Saini
authors.forename: Lorraine
authors.initials: L
authors.lastname: Smith
authors.forename: Kay
authors.initials: K
authors.lastname: Stewart
mesh_terms: D018927:Anti-Asthmatic Agents / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy* / Q000503:physiopathology; D001315:Australia; D003157:Community Pharmacy Services / Q000592:standards*; D004512:Education, Pharmacy / Q000379:methods; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015397:Program Evaluation; D012017:Referral and Consultation; D016896:Treatment Outcome; D014797:Vital Capacity / Q000502:physiology
chemical_list: D018927:Anti-Asthmatic Agents