Introduction
Asthma and chronic obstructive pulmonary disease (COPD) have a significant impact on patients' quality of life, and community pharmacists may be able to help improve asthma control.1–3 Less is known about the impact of pharmacists' interventions on COPD outcomes.4
Methods
We conducted a pilot study involving 21 community pharmacists from the province of Quebec, who assessed 82 patients with a diagnosis of either asthma (n = 23) or COPD (n = 59). Participating pharmacists had to work a minimum of 20 hours per week at the pharmacy and they received $50 for each subject recruited. Pharmacists had to complete a brief continuing education lesson on the management of asthma and COPD before the implementation of the program. Pharmacists used a standardized approach to assess patients (see Box 1). During the assessment, pharmacists reviewed the role of respiratory medication, checked inhalation techniques, assessed disease control/severity, identified potential drug-related problems, evaluated medication adherence and completed referrals to an asthma or COPD educator. A summary was provided to each patient's physician with recommendations if appropriate.
BOX 1 Interventions planned in the assessment.
Results
Overall, pharmacists made 59 recommendations (Table 1). Nine physicians completed and returned a satisfaction questionnaire, and 6 of them reported that the information provided by the pharmacist was very useful (score of 4 or 5 out of 5, 5 being the most useful). Furthermore, all respondents agreed (score of 3 or 4 out of 4, 4 being “completely agree”) with the statements that community pharmacists have the expertise “to assess/monitor drug therapy” and “to identify drug-related problems” for COPD patients. Pharmacists generally appreciated the program, but the lack of time was reported to be a barrier. Self-reported time to complete the assessment was about 30 minutes.
TABLE 1.
Recommendations made by pharmacists to prescribing physicians
Discussion
Lack of time has previously been reported to be a barrier to interventions in asthma by pharmacists.5,6 To overcome this barrier, pharmacists could delegate some tasks to pharmacy interns, pharmacy technicians or nurses employed at the pharmacy.
Footnotes
Financial acknowledgements: Funding for this project was obtained from GSK Canada.
References
- 1.National Asthma Education and Prevention Program Expert Panel Report 3: guidelines for the diagnosis and management of asthma. Summary Report 2007. J Allergy Clin Immunol. 2007;120(5 suppl):S94–S138. doi: 10.1016/j.jaci.2007.09.043. [DOI] [PubMed] [Google Scholar]
- 2.Global Initiative for Chronic Obstructive Lung Disease. 2010. Global strategy for the diagnosis, management, and prevention of chronic obstructive lung disease. Available: www.goldcopd.org/Guidelines/guideline-2010-gold-report.html (accessed January 5, 2010) [Google Scholar]
- 3.Benavides S, Rodriguez JC, Maniscalco-Feichtl M. Pharmacist involvement in improving asthma outcomes in various healthcare settings: 1997 to present. Ann Pharmacother. 2009;43:85–97. doi: 10.1345/aph.1K612. [DOI] [PubMed] [Google Scholar]
- 4.Weinberger M, Murray MD, Marrero DG, et al. Effectiveness of pharmacist care for patients with reactive airways disease: a randomized controlled trial. JAMA. 2002;288:1594–602. doi: 10.1001/jama.288.13.1594. [DOI] [PubMed] [Google Scholar]
- 5.Kritikos VS, Reddel HK, Bosnic-Anticevich SZ. Pharmacists' perceptions of their role in asthma management and barriers to the provision of asthma services. Int J Pharm Pract. 2010;18:209–16. doi: 10.1111/j.2042-7174.2010.00040.x. [DOI] [PubMed] [Google Scholar]
- 6.René-Henri N, Khamla Y, Nadaira N, et al. Community pharmacists' interventions in asthma care: a descriptive study. Ann Pharmacother. 2009;43:104–11. doi: 10.1345/aph.1L308. [DOI] [PubMed] [Google Scholar]