title: Impact of a network system for providing proper inhalation technique by community pharmacists.
abstract: OBJECTIVE
  The availability of many types of inhalers in the treatment of asthma has resulted in a wide range of prescription choices for clinicians. With so many devices available, however, there is some confusion regarding their proper use among both medical staff and patients. Since 2007, Kitano Hospital and Kita-ku Pharmaceutical Association, Osaka, Japan, have provided a network system for delivering instruction on correct inhalation technique through community pharmacists. We examined the clinical effects of this network system.
  
  
  METHODS
  Our measurements included the manner in which community pharmacists instruct patients with asthma, the frequency of asthma exacerbations, patients' adherence to inhalation therapy using a 5-point Likert scale questionnaire, and patients' health status both prior to this system and at 4 years after.
  
  
  RESULTS
  Usable information was obtained from 53 community pharmacists and 146 patients with asthma at baseline and from 60 community pharmacists and 148 patients at 4 years. When compared with baseline values, significant improvement was found in pharmacists' instruction and significant decreases were observed in the frequency of asthma exacerbations (1.4 ± 1.6 vs. 1.0 ± 1.4 times/yr, p = .042) and emergency room visits (0.5 ± 1.0 vs. 0.2 ± 0.5 times/yr, p = .004). Adherence to the inhalation regimen significantly increased (4.0 ± 0.7 vs. 4.2 ± 0.8, p = .041), but health status was unchanged.
  
  
  CONCLUSIONS
  Our network system may improve asthma control and adherence to inhalation regimens.
authors.affiliation: Respiratory Disease Center, Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, Japan. m-takemura@kitano-hp.or.jp
authors.forename: Masaya
authors.initials: M
authors.lastname: Takemura
authors.forename: Katsumi
authors.initials: K
authors.lastname: Mitsui
authors.forename: Masako
authors.initials: M
authors.lastname: Ido
authors.forename: Masataka
authors.initials: M
authors.lastname: Matsumoto
authors.forename: Misuzu
authors.initials: M
authors.lastname: Koyama
authors.forename: Daiki
authors.initials: D
authors.lastname: Inoue
authors.forename: Kazufumi
authors.initials: K
authors.lastname: Takamatsu
authors.forename: Ryo
authors.initials: R
authors.lastname: Itotani
authors.forename: Manabu
authors.initials: M
authors.lastname: Ishitoko
authors.forename: Shinko
authors.initials: S
authors.lastname: Suzuki
authors.forename: Kensaku
authors.initials: K
authors.lastname: Aihara
authors.forename: Minoru
authors.initials: M
authors.lastname: Sakuramoto
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Kagioka
authors.forename: Motonari
authors.initials: M
authors.lastname: Fukui
mesh_terms: D000280:Administration, Inhalation; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage*; D001249:Asthma / Q000188:drug therapy* / Q000523:psychology; D003157:Community Pharmacy Services; D005260:Female; D006801:Humans; D008297:Male; D009330:Nebulizers and Vaporizers / Q000592:standards*; D010353:Patient Education as Topic / Q000379:methods*; D010595:Pharmacists; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires
chemical_list: D018927:Anti-Asthmatic Agents