title: Multidisciplinary intervention to improve albuterol inhaler utilization among patients with asthma.
abstract: The goal of this study was to examine the impact of a multidisciplinary intervention designed to improve appropriate albuterol inhaler utilization among patients with asthma.
  
  
  
  This was a pre-post retrospective analysis. The study intervention included written information sent directly to patients, educated prescribers, and enhanced pharmacist training on appropriate albuterol inhaler utilization. Eligible study patients had a diagnosis of asthma and purchased at least two albuterol inhalers between 07/12/2012 and 06/30/2013 (pre-period) and 7/01/2013 to 06/30/2014 (post-period). The primary outcome was a comparison between study periods of the count of albuterol inhalers purchased per patient per month (PPPM).
  
  
  
  The median age of included patients was 41 years, 53% were females, and allergic rhinitis was the most common comorbidity. The median albuterol inhalers purchased PPPM decreased from 0.60 (interquartile range [IQR] = 0.39-0.87) to 0.37 (IQR = 0.26-0.53) from the pre- to post-period (p < 0.001). The proportion of patients with at least one systemic corticosteroid purchase decreased (36% vs. 31%) and >1 albuterol inhaler purchased on the same day increased (3.1% vs. 5.7%) from the pre- to post-period (p < 0.001). Numerically, the proportion of participants who experienced an acute asthma exacerbation decreased and asthma controller inhalers purchased PPPM increased but these did not reach statistical significance (both p > 0.05).
  
  
  
  A multidisciplinary approach to increasing appropriate albuterol inhaler use was associated with a decrease in albuterol inhalers purchased PPPM while not increasing acute asthma exacerbations. Future study is needed to evaluate patient perspectives on this intervention and assess its economic impact.
authors.affiliation: a Pharmacy Department , Kaiser Permanente Colorado , Aurora , CO , USA.|b Department of Clinical Pharmacy , Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus , Aurora , CO , USA.
authors.forename: Thomas
authors.initials: T
authors.lastname: Delate
authors.affiliation: a Pharmacy Department , Kaiser Permanente Colorado , Aurora , CO , USA.|c School of Pharmacy, Rueckert-Hartman College for Health Professions, Regis University , Denver , CO , USA.
authors.forename: Nathan
authors.initials: N
authors.lastname: Rader
authors.affiliation: a Pharmacy Department , Kaiser Permanente Colorado , Aurora , CO , USA.|b Department of Clinical Pharmacy , Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus , Aurora , CO , USA.
authors.forename: Daniel W
authors.initials: DW
authors.lastname: Jenkins
authors.affiliation: a Pharmacy Department , Kaiser Permanente Colorado , Aurora , CO , USA.|b Department of Clinical Pharmacy , Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus , Aurora , CO , USA.
authors.forename: Ryan
authors.initials: R
authors.lastname: Lowe
mesh_terms: D000280:Administration, Inhalation; D000293:Adolescent; D000328:Adult; D000420:Albuterol / Q000008:administration & dosage / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy*; D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007318:Inservice Training / Q000458:organization & administration; D008297:Male; D055118:Medication Adherence; D036501:Metered Dose Inhalers; D008875:Middle Aged; D010353:Patient Education as Topic / Q000458:organization & administration*; D010593:Pharmaceutical Services / Q000458:organization & administration*; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D001993:Bronchodilator Agents; D000420:Albuterol
keywords: Anti-asthmatic agents; bronchial diseases; corticosteroids; electronic health records; metered dose inhalers