title: An exploration of clinical interventions provided by pharmacists within a complex asthma service.
abstract: BACKGROUND
  Pharmacists in Australia are accessible health care professionals, and their provision of clinical pharmacy interventions in a range of areas has been proven to improve patient outcomes. Individual clinical pharmacy interventions in the area of asthma management have been very successful. An understanding of the nature of these interventions will inform future pharmacy services. What we do not know is when pharmacists provide a complex asthma service, what elements of that service (interventions) they choose to deliver.
  
  
  OBJECTIVE
  To explore the scope and frequency of asthma-related clinical interventions provided by pharmacists to patients in an evidence-based complex asthma service.
  
  
  METHODS
  Pharmacists from 4 states/territories of Australia were trained in asthma management. People with asthma had 3 or 4 visits to the pharmacy. Guided by a structured patient file, the pharmacist assessed the patient's asthma and management and provided interventions where and when considered appropriate, based on their clinical decision making skills. The interventions were recorded in a checklist in the patient file. They were then analysed descriptively and thematically.
  
  
  RESULTS
  Pharmacists provided 22,909 clinical pharmacy interventions over the service to 570 patients (398 of whom completed the service). The most frequently delivered interventions were in the themes 'Education on asthma', 'Addressing trigger factors', 'Medications - safe and effective use' and 'Explore patient perspectives'. The patients had a high and ongoing need for interventions. Pharmacists selected interventions based on their assessment of perceived need then revisited and reinforced these interventions.
  
  
  CONCLUSIONS
  Pharmacists identified a number of areas in which patients required interventions to assist with their asthma management. Many of these were perceived to require continuing reinforcement over the duration of the service. Pharmacists were able to use their clinical judgement to assess patients and provide clinical pharmacy interventions across a range of asthma management needs.
authors.affiliation: Woolcock Institute of Medical Research, The University of Sydney . Sydney, NSW ( Australia ). kate.lemay@sydney.edu.au.
authors.forename: Kate S
authors.initials: KS
authors.lastname: Lemay
authors.affiliation: Faculty of Pharmacy, The University of Sydney . Sydney, NSW ( Australia ). bandana.saini@sydney.edu.au.
authors.forename: Bandana
authors.initials: B
authors.lastname: Saini
authors.affiliation: Woolcock Institute of Medical Research, The University of Sydney ; and Sydney Local Health District. Sydney, NSW ( Australia ). sinthia.bosnic-anticevich@sydney.edu.au.
authors.forename: Sinthia
authors.initials: S
authors.lastname: Bosnic-Anticevich
authors.affiliation: Faculty of Pharmacy, The University of Sydney . Sydney, NSW ( Australia ). lorraine.smith@sydney.edu.au.
authors.forename: Lorraine
authors.initials: L
authors.lastname: Smith
authors.affiliation: Centre for Medicine Use and Safety, Monash University , VIC ( Australia ). Kay.Stewart@monash.edu.
authors.forename: Kay
authors.initials: K
authors.lastname: Stewart
authors.affiliation: School of Pharmacy, Faculty of Health Sciences, Curtin University , Perth, WA ( Australia ). Lynne.Emmerton@curtin.edu.au.
authors.forename: Lynne
authors.initials: L
authors.lastname: Emmerton
authors.affiliation: Charles Sturt University , Orange, NSW ( Australia ). dburton@csu.edu.au.
authors.forename: Deborah L
authors.initials: DL
authors.lastname: Burton
authors.affiliation: Faculty of Pharmacy, The University of Sydney . Sydney, NSW ( Australia ). ines.krass@sydney.edu.au.
authors.forename: Ines
authors.initials: I
authors.lastname: Krass
authors.affiliation: Woolcock Institute of Medical Research, The University of Sydney ; and Sydney Local Health District, Sydney, NSW ( Australia ). carol.armour@sydney.edu.au.
authors.forename: Carol L
authors.initials: CL
authors.lastname: Armour
keywords: Asthma; Australia; Evidence-Based Practice; Pharmaceutical Services; Pharmacists