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Tilly-Gratton A, Lamontagne A, Blais L, Bacon SL, Ernst P, Grad R, Lavoie KL, McKinney ML, Desplats E, Ducharme FM. Physician agreement regarding the expansion of pharmacist professional activities in the management of patients with asthma. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2016; 25:335-342. [PMID: 27774739 DOI: 10.1111/ijpp.12320] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 09/19/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND Asthma control remains suboptimal in Canada. Expansion of pharmacist's professional activities offers the opportunity to improve the interdisciplinary management of patients with asthma. OBJECTIVE The aim of this study was to determine the level of agreement of physicians regarding the expansion of pharmacists' professional activities in the management of asthma patients. METHODS We conducted a survey of randomly selected Quebec physicians in family medicine, paediatrics and emergency medicine. A 102-item questionnaire, including 10 questions regarding pharmacist's expanded professional activities, was sent using the Tailored Design Method. Questions were answered on a 6-point Likert-like scale (0 - strong disagreement to 5 - strong agreement). RESULTS With a 56% response rate, 421 (250 family medicine, 115 paediatric and 56 emergency medicine) physicians participated; the median years of practice (25%, 75%) was 13 (5-21) years and 69% of respondents were women. Physicians were in favour of the expansion of pharmacist's professional activities with strong endorsement rates (rating of ≥4 on a maximum of 5) exceeding 60% for all but three activities: suggesting a written action plan to the physician (55%), adjusting the dose of prescribed asthma medication to achieve a therapeutic target (52%) and offering spirometry testing in pharmacies (45%). Emergency physicians, physicians with fewer years of practice, and those with a favourable perception of an interprofessional approach were associated with higher endorsement of these activities. CONCLUSION Physicians are favourable to the expansion of pharmacist activities in the management of patients with asthma. More complex activities were less frequently endorsed. The characteristics of strong intenders have been identified.
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Affiliation(s)
- Audrey Tilly-Gratton
- Clinical Research and Knowledge Transfer Unit on Childhood Asthma, Research Centre, CHU Sainte-Justine, Montreal, QC, Canada
| | - Alexandrine Lamontagne
- Clinical Research and Knowledge Transfer Unit on Childhood Asthma, Research Centre, CHU Sainte-Justine, Montreal, QC, Canada
| | - Lucie Blais
- Faculty of Pharmacy, University of Montreal, Montreal, QC, Canada
| | - Simon L Bacon
- Department of Exercise Science, Concordia University, Montreal, QC, Canada.,Montreal Behavioural Medicine Centre, Hopital du Sacre-Coeur de Montreal, Montreal, QC, Canada
| | - Pierre Ernst
- Department of Pulmonary Medicine, Jewish General Hospital, Montreal, QC, Canada.,Division of Clinical Epidemiology (MUHC) Epidemiology, Biostatistics and Occupational Health, Montreal, QC, Canada
| | - Roland Grad
- Department of Family Medicine, McGill University, Montreal, QC, Canada
| | - Kim L Lavoie
- Montreal Behavioural Medicine Centre, Hopital du Sacre-Coeur de Montreal, Montreal, QC, Canada.,Department of Psychology, Université du Québec à Montréal, Montreal, QC, Canada
| | - Martha L McKinney
- Department of Pediatrics, University of Montreal, Montreal, QC, Canada
| | - Eve Desplats
- Applied Clinical Research Unit, Research Centre, CHU Sainte-Justine, Montreal, QC, Canada
| | - Francine M Ducharme
- Clinical Research and Knowledge Transfer Unit on Childhood Asthma, Research Centre, CHU Sainte-Justine, Montreal, QC, Canada.,Department of Psychology, Université du Québec à Montréal, Montreal, QC, Canada.,Department of Social and Preventive Medicine, University of Montreal, Montreal, QC, Canada
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Abstract
Asthma is one of the most common respiratory diseases, with immense social impact. Despite best efforts, asthma prevalence, morbidity, and mortality are increasing in the United States. This is especially the case in select communities which suffer an excess burden of asthma. Studying these groups and attempting to ameliorate the disease burden they suffer has an important moral and social imperative. It also may lend important insight into the complex factors that contribute to asthma outcomes. The factors that affect asthma interact in a complicated manner and require a comprehensive approach that addresses each of them. However, pursuing health disparities research is controversial, and important ethical and operative considerations need to be made by those to engage in health disparities research.
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Affiliation(s)
- Hasan Shanawani
- Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, University of Michigan School of Medicine, 3916 Taubman Box 0360, 1500 East Medical Center Drive, Ann Arbor, MI 48109-0360, USA.
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