Therapeutic outcomes monitoring by community pharmacists for improving clinical outcomes in asthma

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Abstract
Objective: To determine the effect of enhanced therapeutic monitoring by community pharmacists on clinical outcomes of a convenience sample of asthma patients. Methods: A one-year intervention study with scheduled visits and follow-ups at baseline, 4, 8, 12 and 24 months using a pre/post-test design, with a small convenience sample of 28 study patients, who performed their own controls. Outcomes measured were the severity of asthma symptoms, changes in the number of patients having peak expiratory flow (PEF) values below 85% or 70% of the optimal, changes in daily asthma medication and number of patients needing courses of oral steroids. Results: A positive change was noticed in all the measures used, most clearly in the severity of asthma symptoms. During the intervention, mean scores of three out of five symptom measures improved significantly. Twenty-two (79%) patients had a net improvement in one or more asthma symptom indicators. The number of patients with PEF values below 85% of the optimal decreased from seven to four at 12 months. The number of patients having courses of oral steroids for asthma decreased. More than half (57%) of the patients had changes in their daily asthma medication. The effects lasted partly over one year after the intervention. Conclusions: The results of this study suggest that pharmacist intervention can have a positive effect on clinical outcomes of asthma patients. The results need to be confirmed with a study using a randomized controlled design.