Development, Implementation, and Evaluation of a Community Pharmacy–Based Asthma Care Model

Abstract

BACKGROUND Pharmacists are uniquely placed in the healthcare system to address critical issues in asthma management in the community. Various programs have shown the benefits of a pharmacist-led asthma care program; however, no such programs have previously been evaluated in Australia. OBJECTIVE To measure the impact of a specialized asthma service provided through community pharmacies in terms of objective patient clinical, humanistic, and economic outcomes. METHODS A parallel controlled design, where 52 intervention patients and 50 control patients with asthma were recruited in 2 distinct locations, was used. In the intervention area, pharmacists were trained and delivered an asthma care model, with 3 follow-up visits over 6 months. This model was evaluated based on clinical, humanistic, and economic outcomes compared between and within groups. RESULTS There was a significant reduction in asthma severity in the intervention group, 2.6 ± 0.5 to 1.6 ± 0.7 (mean ± SD; p < 0.001) versus the control group, 2.3 ± 0.7 to 2.4 ± 0.5. In the intervention group, peak flow indices improved from 82.7% ± 8.2% at baseline to 87.4% ± 8.9% (p < 0.001) at the final visit, and there was a significant reduction in the defined daily dose of albuterol used by patients, from 374.8 ± 314.8 μg at baseline to 198.4 ± 196.9 μg at the final visit (p < 0.015). There was also a statistically significant improvement in perceived control of asthma and asthma-related knowledge scores in the intervention group compared with the control group between baseline and the final visit. Annual savings of $132.84(AU) in medication costs per patient and $100,801.20 for the whole group, based on overall severity reduction, were demonstrated. CONCLUSIONS Based on the results of this study, it appears that a specialized asthma care model offers community pharmacists an opportunity to contribute toward improving asthma management in the Australian community.