Data-mining of medication records to improve asthma management.
OBJECTIVE
To use community pharmacy medication records to identify patients whose asthma may not be well managed and then implement and evaluate a multidisciplinary educational intervention to improve asthma management.


METHODS
We used a multisite controlled study design. Forty-two pharmacies throughout Tasmania ran a software application that "data-mined" medication records, generating a list of patients who had received three or more canisters of inhaled short-acting beta(2)-agonists in the preceding 6 months. The patients identified were allocated to an intervention or control group. Pre-intervention data were collected for the period May to November 2006 and post-intervention data for the period December 2006 to May 2007.


METHODS
Intervention patients were contacted by the community pharmacist via mail, and were sent educational material and a letter encouraging them to see their general practitioner for an asthma management review. Pharmacists were blinded to the control patients' identities until the end of the post-intervention period.


METHODS
Dispensing ratio of preventer medication (inhaled corticosteroids [ICSs]) to reliever medication (inhaled short-acting beta(2)-agonists).


RESULTS
Thirty-five pharmacies completed the study, providing 702 intervention and 849 control patients. The intervention resulted in a threefold increase in the preventer-to-reliever ratio in the intervention group compared with the control group (P < 0.01) and a higher proportion of patients in the intervention group using ICS therapy than in the control group (P < 0.01).


CONCLUSIONS
Community pharmacy medication records can be effectively used to identify patients with suboptimal asthma management, who can then be referred to their GP for review. The intervention should be trialled on a national scale to determine the effects on clinical, social, emotional and economic outcomes for people in the Australian community, with a longer follow-up to determine sustainability of the improvements noted.
Bereznicki
Bonnie J
BJ
Unit for Medication Outcomes Research and Education, School of Pharmacy, University of Tasmania, Hobart, TAS, Australia. Bonnie.Bereznicki@utas.edu.au
Peterson
Gregory M
GM
Jackson
Shane L
SL
Walters
E Haydn
EH
Fitzmaurice
Kimbra D
KD
Gee
Peter R
PR
D018927:Anti-Asthmatic Agents / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy / Q000517:prevention & control*; D003157:Community Pharmacy Services; D019468:Disease Management; D006801:Humans; D016347:Medical Records Systems, Computerized; D036501:Metered Dose Inhalers / Q000706:statistics & numerical data; D010353:Patient Education as Topic / Q000379:methods*; D013648:Tasmania
D018927:Anti-Asthmatic Agents