title: Feasibility and effectiveness of an evidence-based asthma service in Australian community pharmacies: a pragmatic cluster randomized trial.
abstract: OBJECTIVE
  To test the feasibility, effectiveness, and sustainability of a pharmacy asthma service in primary care.
  
  
  METHODS
  A pragmatic cluster randomized trial in community pharmacies in four Australian states/territories in 2009. Specially trained pharmacists were randomized to deliver an asthma service in two groups, providing three versus four consultations over 6 months. People with poorly controlled asthma or no recent asthma review were included. Follow-up for 12 months after service completion occurred in 30% of randomly selected completing patients. Outcomes included change in asthma control (poor and fair/good) and Asthma Control Questionnaire (ACQ) score, inhaler technique, quality of life, perceived control, adherence, asthma knowledge, and asthma action plan ownership.
  
  
  RESULTS
  Ninety-six pharmacists enrolled 570 patients, with 398 (70%) completing. Asthma control significantly improved with both the three- and four-visit service, with no significant difference between groups (good/fair control 29% and 21% at baseline, 61% and 59% at end, p = .791). Significant improvements were also evident in the ACQ (mean change 0.56), inhaler technique (17-33% correct baseline, 57-72% end), asthma action plan ownership (19% baseline, 56% end), quality of life, adherence, perceived control, and asthma knowledge, with no significant difference between groups for any variable. Outcomes were sustained at 12 months post-service.
  
  
  CONCLUSIONS
  The pharmacy asthma service delivered clinically important improvements in both a three-visit and four-visit service. Pharmacists were able to recruit and deliver the service with minimal intervention, suggesting it is practical to implement in practice. The three-visit service would be feasible and effective to implement, with a review at 12 months.
authors.affiliation: Woolcock Institute of Medical Research, The University of Sydney, Sydney, Australia. carol.armour@sydney.edu.au
authors.forename: Carol L
authors.initials: CL
authors.lastname: Armour
authors.forename: Helen K
authors.initials: HK
authors.lastname: Reddel
authors.forename: Kate S
authors.initials: KS
authors.lastname: LeMay
authors.forename: Bandana
authors.initials: B
authors.lastname: Saini
authors.forename: Lorraine D
authors.initials: LD
authors.lastname: Smith
authors.forename: Sinthia Z
authors.initials: SZ
authors.lastname: Bosnic-Anticevich
authors.forename: Yun Ju Christine
authors.initials: YJ
authors.lastname: Song
authors.forename: M Chehani
authors.initials: MC
authors.lastname: Alles
authors.forename: Deborah L
authors.initials: DL
authors.lastname: Burton
authors.forename: Lynne
authors.initials: L
authors.lastname: Emmerton
authors.forename: Kay
authors.initials: K
authors.lastname: Stewart
authors.forename: Ines
authors.initials: I
authors.lastname: Krass
mesh_terms: D000280:Administration, Inhalation; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy* / Q000276:immunology / Q000503:physiopathology; D001315:Australia; D016000:Cluster Analysis; D005240:Feasibility Studies; D005541:Forced Expiratory Volume / Q000187:drug effects; D006801:Humans; D055118:Medication Adherence; D015999:Multivariate Analysis; D010594:Pharmacies / Q000458:organization & administration*; D010595:Pharmacists; D011788:Quality of Life; D014797:Vital Capacity / Q000187:drug effects
chemical_list: D018927:Anti-Asthmatic Agents