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Mahmoud A, Abuhelwa AY, Owen T, Alazzawi A, Shara M, Alqudah MAY, ElHajj MS, Smith JR. Role of pharmacists in the care of adult asthma patients: A scoping review. Res Social Adm Pharm 2024; 20:860-869. [PMID: 38918145 DOI: 10.1016/j.sapharm.2024.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 04/04/2024] [Accepted: 06/13/2024] [Indexed: 06/27/2024]
Abstract
BACKGROUND Asthma is a common long-term condition that affects people of all ages. Evidence suggests that a significant proportion of asthma patients in the Gulf Cooperation Council (GCC) do not receive appropriate diagnosis, monitoring and/or treatment. When inadequately treated, asthma can negatively affect quality of life and may lead to hospitalisation and death. Although pharmacists play a role in asthma care globally, there appears to be no defined role for pharmacists in providing care to patients with asthma in the GCC countries. AIM This scoping review aims to review and summarise studies conducted in the GCC countries involving pharmacists in the management of adults with asthma or evaluating pharmacists' asthma care knowledge and/or skills. METHOD A systematic scoping review was undertaken. Seven databases were searched using relevant search terms for articles published up to May 2023. Studies that evaluated pharmacists roles, knowledge and skills in providing asthma care to adults in the United Arab Emirates (UAE), Qatar, Kuwait, Oman, Saudi Arabia, and Bahrain were considered eligible for inclusion. Extracted data were collated using tables and used to produce narrative descriptive summaries. RESULTS Out of the 1588 search results, only seven studies met the inclusion criteria. Of those, only one developed and tested a pharmacist-led inhaler technique educational intervention in the UAE within community pharmacy setting for asthma patients. The remaining six studies assessed community pharmacists knowledge in providing asthma management and patient education in UAE, Saudi Arabia and Qatar. The quality of the included studies varied with four relying on simulated patients to assess pharmacists knowledge. The study that tested the intervention suggested improvement in inhaler technique and asthma symptoms control after receiving the intervention. The findings suggest a need to improve pharmacists knowledge of inhaler technique demonstration (mainly Metered Dose Inhalers), asthma management advice and assessment of asthma control and medication use. CONCLUSION This review highlights a lack of research on pharmacist-led asthma interventions and identifies training needs to enable pharmacists to be involved in asthma care in the GCC countries. Future research could develop approaches involving pharmacists to improve asthma care and outcomes in the region.
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Affiliation(s)
- Aseel Mahmoud
- Faculty of Health and Life Sciences, University of Exeter, Exeter, UK.
| | - Ahmad Y Abuhelwa
- Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, Sharjah, 27272, United Arab Emirates; Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, 27272, United Arab Emirates
| | - Tom Owen
- Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Amad Alazzawi
- Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Mohd Shara
- Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, Sharjah, 27272, United Arab Emirates; Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, 27272, United Arab Emirates
| | - Mohammad A Y Alqudah
- Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, Sharjah, 27272, United Arab Emirates; Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, 27272, United Arab Emirates; Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, 22110, Jordan
| | | | - Jane R Smith
- Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
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Al-Juhaishi M, Lim CX, Chan V, Stupans I, Thrimawithana TR. Exploring Experiences and Asthma Management Among Middle Eastern Arabic-Speaking Migrants and Refugees with Asthma: A Qualitative Study. Patient Prefer Adherence 2024; 18:1789-1801. [PMID: 39220106 PMCID: PMC11365489 DOI: 10.2147/ppa.s471347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Accepted: 08/03/2024] [Indexed: 09/04/2024] Open
Abstract
Purpose Effective asthma management relies on individuals' knowledge, inhaler technique, and perceptions of asthma and medications. Investigating barriers and enablers to optimal asthma management is vital. This research pursues a comprehensive understanding of asthma control, asthma-related experiences, perceptions, inhaler technique, and knowledge among Arabic-speaking Middle Eastern migrants and refugees living in Australia. Furthermore, it aims to explore the factors influencing optimal asthma management within this demographic. Patients and Methods This study involved interviews with 17 participants, with nine identified as migrants and eight as refugees. All participants were Arabic-speaking Middle Eastern individuals residing in Australia and diagnosed with asthma. Interviews were thematically analysed, and findings were presented following the guidelines of the consolidated criteria for reporting qualitative research (COREQ). Results The thematic analysis yielded five key themes: (1) asthma experiences; (2) participant perspectives on asthma; (3) asthma management; (4) asthma health literacy; and (5) strategies to overcome obstacles in asthma management. Some disparities were noted between refugees and migrants in terms of their comprehension and views on asthma, medications use, interactions with healthcare providers, and inhaler technique. Refugees experienced more psychological distress and lacked social support, while migrants were more concerned about long-term medication use and preferred specialised care. Conclusion This research addresses a knowledge gap concerning asthma control among Middle Eastern immigrants. It provides insights into their beliefs and medication adherence. It underscores the importance of considering the unique characteristics of Middle Eastern migrants and refugees when delivering healthcare interventions to enhance overall health and medication adherence within these populations. To address these differences, the study recommends tailored education, specialised clinics, and culturally relevant asthma management plans to enhance self-management support for both groups. Future studies should explore the impact of modifying beliefs, attitudes, and knowledge regarding medications and asthma to enhance asthma management within this population.
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Affiliation(s)
- Malath Al-Juhaishi
- Discipline of Pharmacy, School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC, 3083, Australia
| | - Chiao Xin Lim
- Discipline of Pharmacy, School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC, 3083, Australia
- Department of Medicine, School of Clinical Sciences, Monash University, Clayton, VIC, 3168, Australia
| | - Vincent Chan
- Discipline of Pharmacy, School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC, 3083, Australia
| | - Ieva Stupans
- Discipline of Pharmacy, School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC, 3083, Australia
| | - Thilini R Thrimawithana
- Discipline of Pharmacy, School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC, 3083, Australia
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Ghozali MT, Mutiara TA. Promoting knowledge of metered dose inhaler (MDI) usage among pharmacy professional students through a mobile app. J Asthma 2024; 61:835-846. [PMID: 38236014 DOI: 10.1080/02770903.2024.2306622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 01/13/2024] [Indexed: 01/19/2024]
Abstract
INTRODUCTION Efficient asthma management necessitates optimal usage of metered-dose inhalers (MDIs). As future health professionals, pharmacy students are pivotal in disseminating accurate methodologies for MDI usage. Despite having hands-on experience, there is room to enhance their comprehension, highlighting the need for prompt patient educational interventions. OBJECTIVE This study aims to evaluate the effectiveness of a mobile app-assisted educational method in improving pharmacy students' understanding of MDI usage. METHODS A pre-experimental study was conducted from March to August 2021 with 45 participants enrolled in the Pharmacist Professional Study Program at the Faculty of Medicine and Health Sciences, Universitas Muhammadiyah Yogyakarta. Using a one-group pretest-post-test design, the study measured the app's impact on students' knowledge and MDI usage skills. RESULTS The intervention significantly improved students' scores on a 9-step MDI usage checklist, with increases ranging from 0.10 to 0.50 across verbal and motor components. A Mann-Whitney U test validated these findings, showing a statistically significant p-value of 0.001. CONCLUSION The mobile app-assisted educational approach substantially enhanced pharmacy students' proficiency in MDI use. The significant rise in mean scores for the 9-step checklist, along with the notable p-value, supports the effectiveness of this intervention in healthcare education.
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Affiliation(s)
- Muhammad Thesa Ghozali
- Department of Pharmaceutical Management, School of Pharmacy, Universitas Muhammadiyah Yogyakarta, Indonesia
| | - Tasya Aulia Mutiara
- Undergraduate Program, School of Pharmacy, Universitas Muhammadiyah Yogyakarta, Indonesia
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Carr T, Tkacz J, Chung Y, Ambrose CS, Spahn J, Rane P, Wang Y, Lindsley AW, Lewing B, Burnette A. Gaps in Care Among Uncontrolled Severe Asthma Patients in the United States. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2024; 12:1775-1782.e2. [PMID: 38508336 DOI: 10.1016/j.jaip.2024.03.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 03/08/2024] [Accepted: 03/11/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND Understanding the implementation of key guideline recommendations is critical for managing severe asthma (SA) in the treatment of uncontrolled disease. OBJECTIVE To assess specialist visits and medication escalation in US patients with SA after events indicating uncontrolled disease (EUD) and associations with health outcomes and social disparity indicators. METHODS Patients with SA appearing in administrative claims data spanning 2015 to 2020 were indexed hierarchically on asthma-related EUD, including hospitalizations, emergency department visits with systemic corticosteroid treatment, or outpatient visits with systemic corticosteroid treatment. Patients with SA without EUD served as controls. Eligibility included age 12 or greater, 12 months enrollment before and after index, no biologic use, and no other major respiratory disease during the pre-period. Escalation of care in the form of specialist visits and medication escalation, health care resource use, costs, and disease exacerbations were assessed during follow-up. RESULTS We identified 180,736 patients with SA (90,368 uncontrolled and 90,368 controls). Between 35% and 51% of patients with SA with an EUD had no specialist visit or medication escalation. Follow-up exacerbations ranged from 51% to 4% across EUD cohorts, compared with 13% in controls. Among uncontrolled patients with SA who were Black or Hispanic/Latino, 41% and 38%, respectively, had no specialist visit or medication escalation after EUD, compared with 33% of non-Hispanic White patients. CONCLUSIONS A substantial proportion of uncontrolled patients with SA had no evidence of specialist visits or medication escalation after uncontrolled disease, and there was a clear relationship between uncontrolled disease and subsequent health care resource use and exacerbations. Findings highlight the need for improved guideline-based care delivery to patients with SA, particularly for those facing social disparities.
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Affiliation(s)
- Tara Carr
- Department of Medicine, University of Arizona, Tucson, Ariz
| | | | | | | | | | | | | | | | | | - Autumn Burnette
- Division of Allergy and Immunology, Howard University, Washington, DC
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Ban AYL, Taher SW, Muneswarao J, Ho BK, Ahmad R, Pereirasamy L, Chong LY, Md Jamal S, Alaga A, Haja Mydin H, Chang LC, Md Isa NA, Mohd Zim MA. National expert consensus on short-acting beta 2-agonist overreliance in asthma care in Malaysia. J Asthma 2024:1-13. [PMID: 38832793 DOI: 10.1080/02770903.2024.2361780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 05/26/2024] [Indexed: 06/05/2024]
Abstract
OBJECTIVE Inappropriate use of short-acting beta2-agonists (SABA) in asthma has been associated with undesired outcomes. This national expert consensus was developed to increase awareness of SABA overuse and provide recommendations on the ways to eliminate SABA overprescription and overreliance in Malaysia. DATA SOURCES This expert consensus was developed by searching the PubMed database, using index terms to identify SABA overuse-related burden and recommendations made in asthma guidelines. Consensus recommendations were made via the Delphi method, involving a Malaysian expert committee comprising 13 healthcare professionals (five pulmonologists, four family medicine specialists, two emergency medicine physicians and two pharmacists). STUDY SELECTIONS The articles reviewed include randomized controlled trials, systematic reviews, meta-analyses, observational studies, guidelines, and surveys, with abstracts in English and published up until June 2023. Relevant recommendations were also sourced from verified websites of medical organizations and societies. RESULTS Eleven consensus statements were developed, each statement achieving a priori agreement level of at least 70%. The statements reflect SABA overreliance in asthma care, as well as recommendations to eliminate SABA overprescription and overreliance in Malaysia. Supporting evidence in the literature as well as expert committee discussions leading to the development of the finalized statements were elaborated. CONCLUSION This national expert consensus discussed the burden of SABA overreliance and made specific recommendations to eliminate SABA overprescription and overreliance in the Malaysian context. This consensus document is anticipated to impart better awareness among Malaysian healthcare providers and contribute to the continuous improvement of asthma care in the country.
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Affiliation(s)
- Andrea Yu-Lin Ban
- Department of Medicine, Hospital Canselor Tuanku Muhriz, Cheras, Kuala Lumpur, Malaysia
| | - Sri Wahyu Taher
- Department of Family Medicine, Klinik Kesihatan Simpang Kuala, Alor Setar, Kedah, Malaysia
| | - Jaya Muneswarao
- Department of Pharmacy, Hospital Pulau Pinang, Penang, Malaysia
| | - Bee Kiau Ho
- Department of Family Medicine, Klinik Kesihatan Bandar Botanik, Klang, Selangor, Malaysia
| | - Rashidi Ahmad
- Department of Emergency Medicine, KPJ Seremban Specialist Hospital, Negeri, Sembilan, Malaysia
| | | | - Li Yin Chong
- Department of Pharmacy, Hospital Sultan Idris Shah Serdang, Kajang, Selangor, Malaysia
| | - Shamsuriani Md Jamal
- Department of Emergency, Hospital Canselor Tuanku Muhriz, Cheras, Kuala Lumpur, Malaysia
| | - Arvindran Alaga
- Department of Family Medicine, Hospital Sultanah Bahiyah, Alor Setar, Kedah, Malaysia
| | - Helmy Haja Mydin
- Department of Lung Centre, Hospital Pantai, Kuala Lumpur, Malaysia
| | - Li Cheng Chang
- Department of Family Medicine, Klinik Kesihatan Kuang, Rawang, Selangor, Malaysia
| | - Nor Azila Md Isa
- Department of Family Medicine, Klinik Kesihatan Nilai, Seremban, Negeri Sembilan, Malaysia
| | - Mohd Arif Mohd Zim
- Department of Respiratory Medicine, Damansara Specialist Hospital 2, Bukit Lanjan, Kuala Lumpur, Malaysia
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Mahmoud A, Mullen R, Penson PE, Morecroft C. Patient experiences of their current asthma care and their views toward providing support for patients with asthma in community pharmacy: A Qualitative study. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2024; 14:100454. [PMID: 38845612 PMCID: PMC11153897 DOI: 10.1016/j.rcsop.2024.100454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 04/18/2024] [Accepted: 05/21/2024] [Indexed: 06/09/2024] Open
Abstract
Background An estimated 300 million people live with asthma globally. In England, a significant percentage live with poorly controlled asthma symptoms. Community pharmacists might be able to play a role in filling gaps in asthma care as they have the expertise and are in regular contact with patients with long term conditions. This study described patients' experiences of the management of their asthma in the general physician (GP) practice and community pharmacy settings and explored patients' views on providing support for them in community pharmacy. Method This is a descriptive qualitative study. Thirteen adult asthma patients were recruited from a GP practice in the Northwest of England. Semi-structured qualitative interviews were conducted face-to-face or by telephone. The interviews were recorded, transcribed and analysed using a thematic analysis approach. Ethics approval was obtained before the study commenced and all participants gave informed written consent to participate. Results We identified challenges in the current asthma care provided to patients with asthma including lack of continuity of care, inability to book an appointment and other experienced differences in the quality of asthma care provided to them and/or access to annual asthma reviews across different GP practices. Additionally, there is lack of awareness of services provided in community pharmacy. These challenges along with having comorbidities alongside asthma may negatively affect asthma patients' engagement with their asthma appointments and their behaviour toward their asthma. Conclusions Patients showed trust in community pharmacists same as other HCPs to support them with their asthma care. Patients thought that being provided with regular asthma care including reviews in community pharmacy might be a suitable approach to respond to patients' needs and preferences in terms of their asthma management because of ease of access to community pharmacy. Pharmacists could be involved in the provision of community pharmacy-based asthma interventions that involve more than inhaler technique education. Further research should focus on developing structured approaches for asthma patient education that can be implemented consistently in the context of community pharmacy in England.
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Affiliation(s)
- Aseel Mahmoud
- Faculty of Health and Life Sciences, University of Exeter, Exeter, United Kingdom
| | - Rachel Mullen
- School of Pharmacy and Biomolecular Sciences, Faculty of Science, Liverpool John Moores University, Liverpool, United Kingdom
- Centre of Pharmacy Innovation, Liverpool John Moores University, Liverpool, United Kingdom
| | - Peter E. Penson
- School of Pharmacy and Biomolecular Sciences, Faculty of Science, Liverpool John Moores University, Liverpool, United Kingdom
- Centre of Pharmacy Innovation, Liverpool John Moores University, Liverpool, United Kingdom
| | - Charles Morecroft
- School of Pharmacy and Biomolecular Sciences, Faculty of Science, Liverpool John Moores University, Liverpool, United Kingdom
- Centre of Pharmacy Innovation, Liverpool John Moores University, Liverpool, United Kingdom
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Ulutas Deniz E, Gülakar AN, Eren R. A qualitative study on asthma management experiences of Turkish community pharmacists. J Asthma 2024; 61:632-642. [PMID: 38108630 DOI: 10.1080/02770903.2023.2297373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 12/16/2023] [Indexed: 12/19/2023]
Abstract
INTRODUCTION Asthma is seen in more than 4 million people in Turkey. Numerous studies have shown the beneficial effects of pharmacist interventions on medication adherence and therapeutic outcomes. The aim of this study was to gain insight into the current situation by examining the experiences of Turkish community pharmacists in relation to the counseling and referral of asthma patients, the responsibilities of pharmacists and the recommendations made by pharmacists to improve asthma management. METHODS In this qualitative study, the constructivist-interpretivist paradigm was adopted. To conduct qualitative interviews, a semi-structured interview guide was devised to gather insights from the pharmacists. The interviews were coded verbatim. Subsequently, various themes and sub-themes were developed based on the aim and objectives of the study. RESULTS A total of 14 pharmacists engaged in semi-structured interviews conducted between June and August 2023. The wealth of information gathered during these interviews facilitated a meticulous thematic analysis, yielding four overarching themes: 1) Patient-related difficulties, 2) Communication with physicians, 3) Desired traits and responsibilities of pharmacists, 4) Pharmacists' expectations. Pharmacists placed significant emphasis on their challenges in allocating time to patients, primarily due to high workloads and limited collaboration with physicians. CONCLUSION Considering the workload and time limitations faced by pharmacists, a collaborative model involving pharmacists and physicians is seen as essential. Enhancing the collaboration between pharmacists and physicians, especially for chronic diseases, holds the potential to enhance public health outcomes while alleviating the workload of pharmacists.
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Affiliation(s)
- Elif Ulutas Deniz
- Department of Pharmacy Management, Faculty of Pharmacy, Atatürk University, Erzurum, Turkey
| | | | - Rumeysa Eren
- Department of Pharmacy Management, Faculty of Pharmacy, Atatürk University, Erzurum, Turkey
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Price D, Jenkins C, Hancock K, Vella R, Heraud F, Le Cheng P, Murray R, Beekman M, Bosnic-Anticevich S, Botini F, Carter V, Catanzariti A, Doan J, Fletton K, Kichkin A, Le T, Le Lievre C, Lau CM, Novic D, Pakos J, Ranasinghe K, Roussos A, Samuel-King J, Sharma A, Stewart D, Willet B, Bateman E. The Association Between Short-Acting β 2-Agonist Over-Prescription, and Patient-Reported Acquisition and Use on Asthma Control and Exacerbations: Data from Australia. Adv Ther 2024; 41:1262-1283. [PMID: 38310584 PMCID: PMC10879376 DOI: 10.1007/s12325-023-02746-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 11/20/2023] [Indexed: 02/06/2024]
Abstract
INTRODUCTION In Australia, short-acting β2-agonists (SABA) are available both over the counter (OTC) and on prescription. This ease of access may impact SABA use in the Australian population. Our aim was to assess patterns and outcome associations of prescribed, acquired OTC and reported use of SABA by Australians with asthma. METHODS This was a cross-sectional study, using data derived from primary care electronic medical records (EMRs) and patient completed questionnaires within Optimum Patient Care Research Database Australia (OPCRDA). A total of 720 individuals aged ≥ 12 years with an asthma diagnosis in their EMRs and receiving asthma therapy were included. The annual number of SABA inhalers authorised on prescription, acquired OTC and reported, and the association with self-reported exacerbations and asthma control were investigated. RESULTS 92.9% (n = 380/409) of individuals issued with SABA prescription were authorised ≥ 3 inhalers annually, although this differed from self-reported usage. Of individuals reporting SABA use (n = 546) in the last 12 months, 37.0% reported using ≥ 3 inhalers. These patients who reported SABA overuse experienced 2.52 (95% confidence interval [CI] 1.73-3.70) times more severe exacerbations and were 4.51 times (95% CI 3.13-6.55) more likely to have poor asthma control than those who reported using 1-2 SABA inhalers. Patients who did not receive SABA on prescription (43.2%; n = 311/720) also experienced 2.71 (95% CI 1.07-7.26) times more severe exacerbations than those prescribed 1-2 inhalers. Of these patients, 38.9% reported using OTC SABA and other prescription medications, 26.4% reported using SABA OTC as their only asthma medication, 13.2% were prescribed other therapies but not SABA OTC and 14.5% were not using any medication. CONCLUSION Both self-reported SABA overuse and zero SABA prescriptions were associated with poor asthma outcomes. The disconnect between prescribing authorisation, OTC availability and actual use, make it difficult for clinicians to quantify SABA use.
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Affiliation(s)
- David Price
- Optimum Patient Care, 5 Coles Lane, Oakington, CB24 3BA, Cambridgeshire, UK.
- Observational and Pragmatic Research Institute, 22 Sin Ming Lane, #06-76, Midview City, 573969, Singapore.
- Division of Applied Health Sciences, Centre of Academic Primary Care, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen, AB25 2ZD, UK.
- Optimum Patient Care Australia, 27 Creek St, Brisbane, QLD, 4000, Australia.
| | - Christine Jenkins
- Thoracic Physician Concord Hospital, Head Respiratory Trials, George Institute, University of Sydney, Sydney, Australia
| | - Kerry Hancock
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Level 3, 207 Bouverie Street, VIC, 3010, Australia
- RACGP Resp Medicine SIG, 100 Wellington Parade, East Melbourne, Melbourne, VIC, 3002, Australia
| | - Rebecca Vella
- Optimum Patient Care Australia, 27 Creek St, Brisbane, QLD, 4000, Australia
| | | | - Porsche Le Cheng
- Optimum Patient Care Australia, 27 Creek St, Brisbane, QLD, 4000, Australia
| | - Ruth Murray
- Optimum Patient Care, 5 Coles Lane, Oakington, CB24 3BA, Cambridgeshire, UK
| | - Maarten Beekman
- BioPharmaceuticals Medical and Regional Medical Director for International, The Hague, The Netherlands
| | - Sinthia Bosnic-Anticevich
- Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
- Woolcock Institute of Medical Research, 431 Glebe Point Road, Glebe, MSW, 2037, Australia
| | - Fabio Botini
- Optimum Patient Care Australia, 27 Creek St, Brisbane, QLD, 4000, Australia
| | - Victoria Carter
- Optimum Patient Care, 5 Coles Lane, Oakington, CB24 3BA, Cambridgeshire, UK
| | - Angelina Catanzariti
- AstraZeneca Biopharmaceuticals Medical, Medical Affairs, 66 Talavera Road, Macquarie Park, NSW, Australia
| | - Joe Doan
- HealthPlus Medical Centre, 28/26 Belgrave St, Kogarah, NSW, 2217, Australia
| | - Kirsty Fletton
- Optimum Patient Care, 5 Coles Lane, Oakington, CB24 3BA, Cambridgeshire, UK
| | - Ata Kichkin
- Blue Shield Family General Practice, Kogarah, NSW, 2217, Australia
| | - Thao Le
- Medical Education, and Events Management Pte Ltd, Singapore, Singapore
| | - Chantal Le Lievre
- Optimum Patient Care Australia, 27 Creek St, Brisbane, QLD, 4000, Australia
| | - Chi Ming Lau
- Toukley Family Practice, 37-41 Canton Beach Road, Toukley, NSW, 2263, Australia
| | - Dominique Novic
- Redlands Medical Centre, 189 Vienna Rd, Alexandra Hills, 4161, Australia
| | - John Pakos
- Woodcroft Medical Centre, Woodcroft, SA, 5162, Australia
| | - Kanchanamala Ranasinghe
- School of Medicine, Griffith University, Gold Coast, Australia
- Cannon Hill Family Doctors, 17/1177 Wynnum Rd, Cannon Hill, QLD, 4170, Australia
| | - Alexander Roussos
- Optimum Patient Care Australia, 27 Creek St, Brisbane, QLD, 4000, Australia
| | | | - Anita Sharma
- Platinum Medical Centre, 18 Banfield St, Chermside, QLD, 4032, Australia
| | - Deb Stewart
- School of Medicine, University of Tasmania, Churchill Ave, Hobart, TAS, 7005, Australia
| | - Bruce Willet
- Victoria Point Surgery, Brisbane, QLD, 4165, Australia
| | - Eric Bateman
- Department of Medicine, University of Cape Town, and University Cape Town Lung Institute, Cape Town, South Africa
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Guzenda W, Żabiński J, Plewka B, Byliniak M, Przymuszała P, Dąbrowiecki P, Michalak M, Waszyk-Nowaczyk M. Inhaler use technique course: an effective postgraduate training solution for pharmacists to enhance therapeutic outcomes as part of patient education. BMC MEDICAL EDUCATION 2024; 24:153. [PMID: 38374024 PMCID: PMC10875814 DOI: 10.1186/s12909-024-05129-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 02/03/2024] [Indexed: 02/21/2024]
Abstract
BACKGROUND Patients with asthma and chronic obstructive pulmonary disease could benefit from education on using inhalers provided by pharmacists. However, pharmacists may have limited competencies, indicating the necessity to implement appropriate postgraduate courses. The study aimed to evaluate an inhaler use course for pharmacists, including its impact on participants' knowledge and satisfaction. METHODS The study involved 261 pharmacists from community pharmacies and was conducted between September 2019 and March 2021. A pre-post analysis of their knowledge of the topic was applied. Additionally, at the beginning of the course, participants were asked about their educational needs, and at the end, they completed a satisfaction survey. The preferred learning formats indicated by participants were interactive workshops and lectures. RESULTS As a result of the course, both their actual and self-assessed level of knowledge significantly increased. The percentage of correct answers in the test before the training was 24.4%, while after, it was 84.3% (p < 0.0001). Before the course, their average self-assessed level of knowledge was 52.0%, and after the training, it increased to 90.0% (p < 0.0001). Almost all respondents stated that the course met their expectations. They estimated their satisfaction at 94.0% and the usefulness of the provided information at 98.0%. CONCLUSIONS Improved preparation of pharmacists resulting from their participation in the course can contribute to providing more professional advice to patients, thereby positively influencing the pharmaceutical care process in community pharmacies.
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Affiliation(s)
- Weronika Guzenda
- Pharmacy Practice and Pharmaceutical Care Division, Chair and Department of Pharmaceutical Technology , Poznan University of Medical Sciences, 3 Rokietnicka Street, 60-806, Poznan, Poland.
| | - Jerzy Żabiński
- Department of Organic and Physical Chemistry, Medical University of Warsaw, 1 Banacha Street, 02-097, Warsaw, Poland
- Mazovian Pharmaceutical Chamber, 01-882, Żeromskiego 77/6 Street, Warsaw, Poland
| | - Beata Plewka
- Pharmacy Practice and Pharmaceutical Care Division, Chair and Department of Pharmaceutical Technology , Poznan University of Medical Sciences, 3 Rokietnicka Street, 60-806, Poznan, Poland
| | | | - Piotr Przymuszała
- Department of Medical Education, Poznan University of Medical Sciences, 7 Rokietnicka Street, 60- 806, Poznan, Poland
| | - Piotr Dąbrowiecki
- Department of Infectious Diseases and Allergology, Military Institute of Medicine, 128 Szaserów Street, 04-141, Warsaw, Poland
| | - Michał Michalak
- Chair and Department of Computer Science and Statistics, Poznan University of Medical Sciences, 7 Rokietnicka Street, 60-806, Poznan, Poland
| | - Magdalena Waszyk-Nowaczyk
- Pharmacy Practice and Pharmaceutical Care Division, Chair and Department of Pharmaceutical Technology , Poznan University of Medical Sciences, 3 Rokietnicka Street, 60-806, Poznan, Poland
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Al-hamaden RA, Abed A, Khader HA, Hasoun L, Al-Dulaimi AH, Alsayed AR. Knowledge and Practice of Healthcare Professionals in the Medical Care of Asthma Adult Patients in Jordan with a Particular Reference to Adherence to GINA Recommendations. J Multidiscip Healthc 2024; 17:391-404. [PMID: 38292919 PMCID: PMC10826525 DOI: 10.2147/jmdh.s433149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 01/15/2024] [Indexed: 02/01/2024] Open
Abstract
Purpose This study aimed to evaluate Jordanian healthcare professionals' knowledge, skills, and experience in dealing with and treating adult asthmatic patients and assess healthcare professionals' compliance with the Global Initiative for Asthma (GINA) guideline recommendations for asthma treatment and management in Jordan. Patients and Methods A cross-sectional survey was conducted in Jordan between May and June 2023. This study included physicians, pharmacists, and nurses working in clinical settings and directly interacting with asthma patients in Jordan's private and governmental healthcare facilities who were eligible to participate in this research. Three primary sections of an online survey were constructed using Google Forms and included demographic data, a diagnosis and management of the illness, and a list of worldwide medical references for asthma. Results A total of 300 healthcare professionals, including pharmacists (103), nurses (87), Doctor of Pharmacy (28), and physicians (82), took part in this research. The survey respondents' general knowledge of the nature and symptoms of asthma is quite high, exceeding 84% and 86%, respectively. The survey also showed a high degree of awareness of asthma diagnosis. It was also revealed that around one-quarter of participants consistently reported the severity of asthma. The most frequent factor influencing the decision to take controller or maintenance medicines is symptom severity (reported from 86% of participants). The GINA guidelines were selected as the asthma information source by almost half of the participants. Finally, 47% of participants were aware of the GINA's 2019 adjustments of the recommendations. Conclusion This study showed that Jordanian healthcare professionals understand the nature, symptoms, and diagnoses of asthma disease. However, many of the survey participants lack adherence, awareness, and understanding of the GINA recommendations about asthma management. More research is required to assess the adherence to the evidence-based recommendations and evaluate the impact of training courses.
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Affiliation(s)
- Rana Ahmad Al-hamaden
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Anas Abed
- Pharmacological and Diagnostic Research Centre, Faculty of Pharmacy, Al-Ahliyya Amman University, Amman, Jordan
| | - Heba A Khader
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmaceutical Sciences, The Hashemite University, Zarqa, Jordan
| | - Luai Hasoun
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | | | - Ahmad R Alsayed
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
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Jarab AS, Al-Qerem W, Alzoubi KH, Almomani N, Abu Heshmeh SR, Mukattash TL, Al Hamarneh YN, Al Momany EM. Role of Community Pharmacist in Asthma Management: Knowledge, Attitudes and Practice. J Multidiscip Healthc 2024; 17:11-19. [PMID: 38192737 PMCID: PMC10771773 DOI: 10.2147/jmdh.s442396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 12/13/2023] [Indexed: 01/10/2024] Open
Abstract
Purpose To investigate knowledge, attitude, and practice of asthma management counseling and the perceived barriers by community pharmacists. Methods This cross-sectional study was conducted on 416 community pharmacists using an online-based questionnaire. The questionnaire included five parts that assessed socio-demographics and medical references used to seek drug-related information, pharmacists' knowledge (7 items), attitudes (5 items), practice (22 items) and the barriers for the provision of asthma management counseling (10 items). Binary logistic regression was conducted to find the variables that were significantly and independently associated with knowledge, attitude and asthma management counseling practice. Results Increased years of experience was associated with decreased knowledge (OR = 0.918, 95% Cl (0.869:0.970), P = 0.002) and less positive attitude toward asthma management (OR = 0.876, 95% Cl. (0.821:0.935), P < 0.001), while working in independent community pharmacy (OR = 2.097, 95% Cl. (1.273:3.454), P = 0.004) and increased awareness of asthma management guidelines (OR = 1.60, 95% CI. (1.044:2.453), P = 0.031) increased the odds of being in the high knowledge group. In contrast, increasing the daily number of pharmacy visitors OR = 1.009, 95% Cl. (1.001:1.016), P = 0.024) and having a pharmacy degree (OR = 2.330, 95% Cl. (1.256:4.326), P = 0.007) increased the odds of having a positive attitude. Male pharmacists (OR = 0.553, 95% Cl. (0.350:0.873), P = 0.011) and having bachelor in pharmacy (OR = 0.354, 95% Cl. (0.179:0.700), P = 0.003) decreased the odds of being in the high practice group. On the other hand, increased awareness of asthma management guidelines tripled the odds of being in the high practice group (OR = 3.067, 95% Cl. (1.964:4.787), P < 0.001). Conclusion The current study findings offer valuable insights into the gaps in knowledge, attitude, and practice of asthma management counseling among community pharmacists, as well as the barriers and factors that impede the provision of these services. These insights serve as a guide for developing future strategies aimed at enhancing the role of pharmacists in asthma care.
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Affiliation(s)
- Anan S Jarab
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
- College of Pharmacy, Al Ain University, Abu Dhabi, United Arab Emirates
- AAU Health and Biomedical Research Center, Al Ain University, Abu Dhabi, United Arab Emirates
| | - Walid Al-Qerem
- Department of Pharmacy, Al-Zaytoonah University of Jordan, Amman, Jordan
| | - Karem H Alzoubi
- Department of Pharmacy Practice and Pharmacotherapeutics, University of Sharjah, Sharjah, United Arab Emirates
- Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Nadeen Almomani
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Shrouq Riad Abu Heshmeh
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Tareq L Mukattash
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | | | - Enaam M Al Momany
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmaceutical Sciences, The Hashemite University, Zarqa, Jordan
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12
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Lin G, Chau CI, Hu H, Ung COL. Pharmacist intervention for pediatric asthma: A systematic literature review and logic model. Res Social Adm Pharm 2023; 19:1487-1510. [PMID: 37679253 DOI: 10.1016/j.sapharm.2023.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 08/04/2023] [Accepted: 08/20/2023] [Indexed: 09/09/2023]
Abstract
BACKGROUND Asthma is highly prevalent in children. Evidence about pharmacist-led interventions in the management of pediatric asthma is emerging. OBJECTIVE To summarize empirical evidence of pharmacist-led interventions for pediatric asthma patients, and to identify the components of a logic model, which can inform evidence-based pharmacy practice. METHODS PubMed, Web of Science, Embase Scopus, ScienceDirect, Medline and CNKI were searched. Studies concerning pharmacist-led interventions for pediatric asthma patients with an interventional design published between January 2013 and February 2023 were selected for analysis. Literature was searched and retrieved according to PRISMA guidelines. Components of pharmacist-led interventions were compiled into a logic model comprising input, activity, output, outcome and contextual factors. RESULTS The initial search retrieved 2291 records and 35 were included in the analysis. The main interventional activities included optimising medicines use and prevention and control of asthma. Commonly reported outputs were medication adherence, knowledge and inhaler technique. The main economic outcomes included cost of medication and hospitalization; clinical outcomes included Childhood Asthma Control Test/Asthma Control Test scores and lung function in FEV1% and PEF%; humanistic outcomes included patients' quality of life and satisfaction. Social, economic, political, and technological factors were identified as contextual factors. CONCLUSION The logic model summarized components of interventions evaluated in literature. It provides a blueprint for pharmacist-led management of pediatric asthma. Further research can focus on the pharmacists' role in a multidisciplinary healthcare professional team and transition of care in patient-centered management of pediatric asthma.
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Affiliation(s)
- Guohua Lin
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao
| | - Chi Ian Chau
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao
| | - Hao Hu
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao; Department of Public Health and Medicinal Administration, Faculty of Health Sciences, University of Macau, Macao
| | - Carolina Oi Lam Ung
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao; Department of Public Health and Medicinal Administration, Faculty of Health Sciences, University of Macau, Macao.
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Park SY, Kim KS, Lee WY, Kim CE, Lee S. Integrative Approach to Identifying System-Level Mechanisms of Chung-Sang-Bo-Ha-Hwan's Influence on Respiratory Tract Diseases: A Network Pharmacological Analysis with Experimental Validation. PLANTS (BASEL, SWITZERLAND) 2023; 12:3024. [PMID: 37687271 PMCID: PMC10489874 DOI: 10.3390/plants12173024] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 08/19/2023] [Accepted: 08/21/2023] [Indexed: 09/10/2023]
Abstract
Chung-Sang-Bo-Ha-Hwan (CSBHH) is an herbal prescription widely used to treat various chronic respiratory diseases. To investigate the system-level treatment mechanisms of CSBHH in respiratory tract diseases, we identified 56 active ingredients of CSBHH and evaluated the degree of overlap between their targets and respiratory tract disease-associated proteins. We then investigated the respiratory tract disease-related signaling pathways associated with CSBHH targets. Enrichment analysis showed that the CSBHH targets were significantly associated with various signaling pathways related to inflammation, alveolar structure, and tissue fibrosis. Experimental validation was conducted using phorbol-12-myristate-13-acetate (PMA)-stimulated NCI-H292 cells by analyzing the mRNA expression levels of biomarkers (IL-1β and TNF-α for inflammation; GSTP1, GSTM1, and PTEN for apoptosis) derived from network pharmacological analysis, in addition to the mucin genes MUC5AC and MUC2, to investigate the phlegm-expelling effect of CSBHH. The mRNA expression levels of these genes were consistent with network pharmacological predictions in a concentration-dependent manner. These results suggest that the therapeutic mechanisms of CSBHH in respiratory tract diseases could be attributed to the simultaneous action of multiple active ingredients in the herbal prescription.
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Affiliation(s)
- Sa-Yoon Park
- Department of Physiology, College of Korean Medicine, Gachon University, Seongnam 13120, Republic of Korea; (S.-Y.P.); (W.-Y.L.)
| | - Kang-Sub Kim
- College of Korean Medicine, Gachon University, Seongnam 13120, Republic of Korea;
| | - Won-Yung Lee
- Department of Physiology, College of Korean Medicine, Gachon University, Seongnam 13120, Republic of Korea; (S.-Y.P.); (W.-Y.L.)
| | - Chang-Eop Kim
- Department of Physiology, College of Korean Medicine, Gachon University, Seongnam 13120, Republic of Korea; (S.-Y.P.); (W.-Y.L.)
| | - Sullim Lee
- Department of Life Science, College of Bio-Nano Technology, Gachon University, Seongnam 13120, Republic of Korea
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Lavenue A, Simoneau I, Mahajan N, Srirangan K. Development and Implementation of Workshops to Optimize the Delivery of Vaccination Services in Community Pharmacies: Thinking beyond COVID-19. PHARMACY 2023; 11:129. [PMID: 37624084 PMCID: PMC10458354 DOI: 10.3390/pharmacy11040129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 08/01/2023] [Accepted: 08/09/2023] [Indexed: 08/26/2023] Open
Abstract
Vaccines are widely recognized as the most economically efficient strategy to combat infectious diseases. Community pharmacists, being highly accessible healthcare professionals, have the potential to significantly contribute to the promotion and facilitation of vaccination uptake. In Canada, the jurisdiction of healthcare falls under provincial legislation, leading to variations in the extent of pharmacist practice throughout the country. While some pharmacists in Canada already functioned as immunizers, Québec pharmacists gained the authority to prescribe and administer vaccines in March 2020 amidst the COVID-19 pandemic. Our workshop aimed to equip pharmacists in Québec with the necessary guidance to optimize vaccinations, emphasizing the importance of maintaining and expanding immunization services beyond influenza and COVID-19 vaccines in the future. During the workshop, pharmacists had the opportunity to exchange valuable insights and best practices regarding workflow optimization, identifying areas for improvement in competency, effectively reaching vulnerable population groups, and integrating allied team members into their practice. Participants were also asked to develop a plan of action to help implement practice change beyond the workshop. Interactive workshops centered around discussions like these serve as catalysts for advancing the pharmacy profession, uniting professionals with a collective aim of enhancing patient care.
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Affiliation(s)
- Arnaud Lavenue
- Toc Toc Communications, 104-7030 Rue Marconi, Montréal, QC H2S 3K1, Canada; (I.S.); (N.M.); (K.S.)
| | - Isabelle Simoneau
- Toc Toc Communications, 104-7030 Rue Marconi, Montréal, QC H2S 3K1, Canada; (I.S.); (N.M.); (K.S.)
| | - Nikita Mahajan
- Toc Toc Communications, 104-7030 Rue Marconi, Montréal, QC H2S 3K1, Canada; (I.S.); (N.M.); (K.S.)
- School of Pharmacy, University of Waterloo, 10A Victoria Street S., Kitchener, ON N2G 1C5, Canada
| | - Kajan Srirangan
- Toc Toc Communications, 104-7030 Rue Marconi, Montréal, QC H2S 3K1, Canada; (I.S.); (N.M.); (K.S.)
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15
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Md Khairi LNH, Gnanasan S. Emerging Roles of Malaysian Pharmacists in Asthma Management Amidst the COVID-19 Pandemic: A Narrative Review. Malays J Med Sci 2023; 30:33-47. [PMID: 37655143 PMCID: PMC10467601 DOI: 10.21315/mjms2023.30.4.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 03/01/2022] [Indexed: 09/02/2023] Open
Abstract
The arrival of COVID-19 pandemic in March 2020 adversely affected every aspect of human life, including the management of asthma. The pandemic has forced clinicians to revisit the application of high-risk aerosol-generating procedures in asthma management, including spirometry and nebuliser therapy. The use of commercial spacers with pressurised metered-dose inhalers to replace nebulisation is limited by the high cost and pandemic-induced stock unavailability of these inhalers. The need for social distancing, healthcare reserves reallocation, and scarce personal protective equipment has promote increased telemedicine uptake for patients' asthma control and monitoring. Malaysian pharmacists have been providing long-term care of asthma through the introduction of the respiratory Medication Therapy Adherence Clinic (MTAC) to empower patients' general health literacy, train and regularly evaluate their inhalation technique, and reinforce the importance of medication compliance. To minimise the use of unplanned healthcare resources and avoidable COVID-19 infection exposure, Malaysian pharmacists need to better support asthma self-management via increased uptake of written Asthma Action Plans (AAPs). Pharmacist-led asthma treatment step-down to attain the lowest effective dose of inhaled corticosteroids (ICS) has become increasingly relevant during the pandemic, as its prolonged use carries risk of numerous side effects and possible hospitalisation. Telepharmacy offers a promising model for exploration and an alternative to the traditional service delivery of asthma education. Despite not being authorised as vaccinators, Malaysian pharmacists hold strong positions in COVID-19 immunisation programmes for pharmacovigilance and advocacy. The pandemic demands an increased role for pharmacists within medication management to prevent patients from the stockpiling that can cause adverse effects on pharmaceutical supply chain. This review intends to summarise the impact of COVID-19 on asthma management, with a focus on the transitional roles of Malaysian pharmacists before and after the pandemic era.
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Affiliation(s)
- Lukman Nul Hakim Md Khairi
- Department of Clinical Pharmacy, Faculty of Pharmacy, Universiti Teknologi MARA, Selangor, Malaysia
- Department of Pharmacy, Hospital Sultanah Nur Zahirah, Ministry of Health Malaysia, Terengganu, Malaysia
| | - Shubashini Gnanasan
- Department of Clinical Pharmacy, Faculty of Pharmacy, Universiti Teknologi MARA, Selangor, Malaysia
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16
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Amirav I, Garcia G, Le BK, Barria P, Levy G, Aggarwal B, Fahrbach K, Martin A, Phansalkar A, Sriprasart T. SABAs as Reliever Medications in Asthma Management: Evidence-Based Science. Adv Ther 2023; 40:2927-2943. [PMID: 37280414 PMCID: PMC10244083 DOI: 10.1007/s12325-023-02543-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 05/04/2023] [Indexed: 06/08/2023]
Abstract
The role of as-needed inhaled short-acting β2-agonists (SABAs) in the management of asthma has become a subject of debate due to differing opinions in the professional community relating to the use of SABAs. In this article, we summarize the current position of SABAs when used as reliever medications and examine the challenges to appropriate use including a critique of the data that have led to the condemnation of SABA used as a reliever. We consider the evidence for the appropriate use of SABA as a reliever together with practical solutions to ensure such use, including identifying patients at risk of misusing their SABA relievers and managing issues of inhaler technique and treatment adherence. We conclude that inhaled corticosteroid (ICS)-based maintenance treatment with SABA used as-needed as a reliever is an effective and safe treatment for patients with asthma, with no scientific evidence of a causal link between SABA use as a reliever and mortality or serious adverse events (including exacerbations). Increased SABA use warns of a deterioration in asthma control, and patients at risk of misusing their ICS and SABA medication should be rapidly identified to ensure they are receiving adequate ICS-based controller therapy. Appropriate use of ICS-based controller therapy and as-needed SABA should be encouraged and promoted with educational activities.
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Affiliation(s)
- Israel Amirav
- Pediatric Pulmonology Unit, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
| | - Gabriel Garcia
- Servicio de Neumonología, Hospital Rossi La Plata, Buenos Aires, Argentina
| | - Bao Khac Le
- University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Paulina Barria
- Unidad de Respiratorio, Hospital Clínico de la Fuerza Aérea de Chile, Santiago, Chile
| | - Gur Levy
- Respiratory Medical Emerging Markets, GSK, Ciudad de Panamá, Panamá
| | | | | | | | | | - Thitiwat Sriprasart
- Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
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Maulood KB, Khan M, Syed Sulaiman SA, Khan AH. Assessing the Impact of Health Education Intervention on Asthma Knowledge, Attitudes, and Practices: A Cross-Sectional Study in Erbil, Iraq. Healthcare (Basel) 2023; 11:1886. [PMID: 37444720 DOI: 10.3390/healthcare11131886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 06/16/2023] [Accepted: 06/27/2023] [Indexed: 07/15/2023] Open
Abstract
Asthma causes chronic coughing, wheezing, dyspnea, and chest pressure. This study assessed asthmatic patients' knowledge, attitudes, and practice (KAP) of bronchial asthma and proper education on its meaning, risk factors, symptoms, diagnosis, management, and prevention practices. We performed a cross-sectional interventional asthma KAP survey in Erbil, Iraq. We adapted a validated study questionnaire from KAP studies in other nations to the Erbil situation and culture. In Erbil, Kurdistan, Iraq, two major hospitals' asthma clinics were studied. We chose 250 asthmatic patients from October 2018 to July 2019. Health education was comprehensive. The health education program used a Kurdish PowerPoint with a printout. Twenty-five groups received two weeks of one-hour health education pre-intervention. Each group was questioned before, 2 weeks after, and 12 weeks after health education. All data were analyzed by SPSS v26. The mean age of the respondents was 37.52 ± 15.16, with 48.7% of the respondents having a positive family history of asthma. After 2 weeks of health education intervention, respondents had a higher knowledge score and positive attitudes compared to pre-education, and after 12 weeks of education, there was a significant difference (p < 0.001) with improvised prevention practice. Health education programs led to considerable improvements in asthmatic patients' knowledge, attitudes, and practices regarding their condition. After receiving health education for a period of two weeks, the majority of the participants answered correctly regarding asthma, its causes, and the elements that trigger asthma attacks.
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Affiliation(s)
- Karwan Bahram Maulood
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, Gelugor 11700, Malaysia
| | - Mohammad Khan
- School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu 16150, Malaysia
- New Age Health Science Research Center, Aturar Dipu, Muradpur, Chittagong 4231, Bangladesh
| | | | - Amer Hayat Khan
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, Gelugor 11700, Malaysia
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Abu-Farha R, Alzoubi KH, Alkhawaldeh R, Awwad O, Mukattash T, Alefishat E. Public satisfaction with community pharmacists roles as healthcare providers: a cross-sectional study from Jordan. JOURNAL OF PHARMACEUTICAL HEALTH SERVICES RESEARCH 2022. [DOI: 10.1093/jphsr/rmac058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Abstract
Objectives
In recent years, the responsibilities of community pharmacists have changed significantly. This study aimed to assess Jordanian public satisfaction with community pharmacists’ role as healthcare providers and to evaluate factors affecting their satisfaction level.
Methods
This cross-sectional questionnaire study was conducted among the Jordanian public using a convenience sampling approach between May 2022 and June 2022. A link to the self-administered questionnaire was distributed via different social media platforms to be filled by participants willing to participate to evaluate their views and satisfaction of community pharmacists’ role as healthcare providers.
Key findings
In this study, 710 participants agreed to participate in this study. The participants had a median age of 36.0 years and 62.3% of them were female. The most frequent reason for visiting any community pharmacy was purchasing prescription medications (83.1%). The location of the pharmacy was the most selected factor influencing the choice of a particular community pharmacy by the study participants (89.3%). Results showed that respondents had an acceptable satisfaction score about pharmacists’ behaviours and roles (median score of 32.0 out of 40.0). More than 80% of the participants were satisfied with the language used by the pharmacist in discussing drug-related matters (84.9%), with the privacy maintained by the pharmacist while dealing with them (83.1%), with pharmacists’ professionalism in dealing with patients (82.3%), and with the positive relationship between pharmacists and patients (81.0%). Respondents with a higher level of education showed more satisfaction towards pharmacists’ services compared to those with lower levels of education (Beta = 0.088, P = 0.031).
Conclusions
This study demonstrated an acceptable general satisfaction of community pharmacists while conducting their job, yet their role still mainly involves dispensing prescriptions.
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Affiliation(s)
- Rana Abu-Farha
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University , Amman , Jordan
| | - Karem H Alzoubi
- Department of Pharmacy Practice and Pharmacotherapeutics, University of Sharjah , Sharjah , United Arab Emirates
- Department of Clinical Pharmacy, Jordan University of Science and Technology , Irbid , Jordan
| | - Rama Alkhawaldeh
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University , Amman , Jordan
| | - Oriana Awwad
- Department Biopharmaceutics and Clinical Pharmacy, Faculty of Pharmacy, The University of Jordan , Amman , Jordan
| | - Tareq Mukattash
- Department of Clinical Pharmacy, Jordan University of Science and Technology , Irbid , Jordan
| | - Eman Alefishat
- Department Biopharmaceutics and Clinical Pharmacy, Faculty of Pharmacy, The University of Jordan , Amman , Jordan
- Department of Pharmacology, College of Medicine and Health Science, Khalifa University of Science and Technology , Abu Dhabi , United Arab Emirates
- Center for Biotechnology, Khalifa University of Science and Technology , Abu Dhabi , United Arab Emirates
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Serhal S, Krass I, Emmerton L, Bereznicki B, Bereznicki L, Bosnic-Anticevich S, Saini B, Billot L, Armour C. Patient uptake and outcomes following pharmacist-initiated referrals to general practitioners for asthma review. NPJ Prim Care Respir Med 2022; 32:53. [DOI: 10.1038/s41533-022-00315-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 10/21/2022] [Indexed: 11/18/2022] Open
Abstract
AbstractUptake and outcomes of pharmacist-initiated general practitioner (GP) referrals for patients with poorly controlled asthma were investigated. Pharmacists referred at-risk patients for GP assessment. Patients were categorized as action takers (consulted their GP on pharmacist’s advice) or action avoiders (did not action the referral). Patient clinical data were compared to explore predictors of uptake and association with health outcomes. In total, 58% of patients (n = 148) received a GP referral, of whom 78% (n = 115) were action takers, and 44% (n = 50) reported changes to their asthma therapy. Patient rurality and more frequent pre-trial GP visits were associated with action takers. Action takers were more likely to have an asthma action plan (P = 0.001) at month 12, and had significantly more GP visits during the trial period (P = 0.034). Patient uptake of pharmacist-initiated GP referrals was high and led to GP review and therapy changes in patients with poorly controlled asthma.
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Advances in Pharmacy Practice: A Look towards the Future. PHARMACY 2022; 10:pharmacy10050125. [PMID: 36287446 PMCID: PMC9608826 DOI: 10.3390/pharmacy10050125] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 09/21/2022] [Accepted: 09/21/2022] [Indexed: 11/07/2022] Open
Abstract
This review looks at the factors that may influence practice in the future. Transformation could occur at 3 levels. Firstly, the traditional profession of the pharmacist as a dispenser of medicines is expanding. Secondly, the pharmacist’s activities are progressing into new healthcare fields. Thirdly, other changes are stimulated by global developments. This review may be helpful for pharmacy and healthcare leaders looking at the future configuration and aims of their pharmacy services.
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Usami O. Improved inhaler handling after repeated inhalation guidance for elderly patients with bronchial asthma and chronic obstructive pulmonary disease. Medicine (Baltimore) 2022; 101:e30238. [PMID: 36107520 PMCID: PMC9439803 DOI: 10.1097/md.0000000000030238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Accurate evaluation of inhaler handling is essential for improved treatment of bronchial asthma (BA) and chronic obstructive pulmonary disease (COPD). Many studies have described the correlation between age, inhalation guidance, and procedure improvement. Elderly patients should receive proper inhalation guidance. This was a retrospective open cohort study conducted at a single hospital with outpatient open pharmacies that provided inhalation guidance to patients of BA and COPD. A total of 525 cases were included in the study. The median age was 71 years with no significant difference between genders (males: 71 ± 16.0 years; females: 72 ± 16.1 years; P = .24). There were 226 males (43.0%) and 299 females (57.0%; P = .03). BA was significantly more prevalent than COPD (P < .001). There was no significant difference in dry powder inhaler (DPI) and pressurized metered-dose inhaler (pMDI) visits in those <60 years of age (P = .23). pMDI was used significantly more often than DPI in those aged 60 to 90 years of age (P < .001). In both <70 and >70 years of age, the most common error with DPI use was improper inhalation speed, which reduced (improved) at the third visit. Gargling errors were most common with DPI use at the second visit and with pMDI at the first visit in both age groups, which subsequently reduced rapidly. Continuous repeated guidance steadily and significantly decreased errors with all devices (P < .001 for DPI, pMDI, and soft mist inhaler). Elderly cases (>70 years of age) should undergo continuous repeated guidance to reduce inhalation errors like inhalation speed and gargling errors.
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Affiliation(s)
- Osamu Usami
- Department of Respiratory Medicine of the Kurihara Central Hospital, Miyagi, Japan
- *Correspondence: Osamu Usami, Department of Respiratory Medicine, Kurihara Central Hospital, Miyano Cyuo 3-11, Tsukidate, Kurihara, Miyagi 987-2205, Japan (e-mail: )
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22
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Turcotte C, Fénélon-Dimanche R, Lemière C, Beauchesne MF, Abou-Atmé B, Chabot I, Blais L. Development of a community pharmacy-based intervention for patients with uncontrolled asthma. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2022; 7:100167. [PMID: 36051610 PMCID: PMC9424560 DOI: 10.1016/j.rcsop.2022.100167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 07/09/2022] [Accepted: 08/05/2022] [Indexed: 11/02/2022] Open
Abstract
Background Objective Methods Results Conclusions
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23
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Said ASA, Hussain N, Kharaba Z, Al Haddad AHI, Abdelaty LN, Roshdy RRS. Knowledge, attitude, and practice of pharmacists regarding asthma management: a cross-sectional study in Egypt. J Pharm Policy Pract 2022; 15:35. [PMID: 35505447 PMCID: PMC9062855 DOI: 10.1186/s40545-022-00432-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 04/18/2022] [Indexed: 12/14/2022] Open
Abstract
Background Asthma is a significant public health issue that poses a substantial health and economic burden. Despite the availability of effective asthma medications, its management remain suboptimal. Recent asthma guidelines have highlighted the importance of pharmacist unique position and its interventional strategies in positively impacting asthma treatment outcomes. Therefore, this study aimed to assess the degree of Egyptian pharmacists’ knowledge, attitudes, as well as their practices towards asthma management in line with the recent asthma guidelines. Methods This cross-sectional study was conducted among 800 pharmacists working in different private and governmental sectors. The data were collected using a 37-item pre-validated self-administered KAP questionnaire. The data were analyzed using Student’s t-test and analysis of variance to assess the association between each KAP level and the sociodemographic variables at the significance level of 0.05. Results Of the 800 distributed questionnaire, a total of 550 participants (316 Male, and 234 Female) responded, representing a 68.7% response rate. The mean ± SD score of knowledge, attitude, practice, and barrier was 5.49 ± 1.65 (min = 0; max = 8), 23.5 ± 2.84 (min = 15, max = 30), 43.12 ± 8.61 (min = 28, max = 62), and 27.76 ± 3.72 (min = 17, max = 39), respectively. The results showed that poor knowledge, attitude, and practice scores were achieved by 30.54, 0, and 38.72% of participants, respectively. Conclusion Our findings revealed the inconsistencies between poor pharmacists’ knowledge and practices with respect to their positive attitudes. The lack of pharmacists’ knowledge and compliance to recent GINA guidelines in this study highlight the crucial need for effective Educational strategies that should better equip pharmacists for their potential role in asthma care.
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Affiliation(s)
- Amira S A Said
- Department of Clinical Pharmacy, College of Pharmacy, Al Ain University, Al Ain, Abu Dhabi, UAE. .,AAU Health and Biomedical Research Center (HBRC), Al Ain University, Abu Dhabi, UAE. .,Department of Clinical Pharmacy, Faculty of Pharmacy, Beni-Suef University, Beni Suef, Egypt.
| | - Nadia Hussain
- AAU Health and Biomedical Research Center (HBRC), Al Ain University, Abu Dhabi, UAE.,Department of Pharmaceutical Sciences, College of Pharmacy, Al Ain University, Al Ain, Abu Dhabi, UAE
| | - Zelal Kharaba
- Department of Clinical Pharmacy, College of Pharmacy, Al Ain University, Al Ain, Abu Dhabi, UAE.,AAU Health and Biomedical Research Center (HBRC), Al Ain University, Abu Dhabi, UAE
| | - Amal H I Al Haddad
- Chief Operations Office, Sheikh Shakbout Medical City (SSMC), Abu Dhabi, UAE
| | - Lamiaa N Abdelaty
- Department of Clinical Pharmacy, Faculty of Pharmacy, October 6 University, Cairo, Egypt
| | - Raghda R S Roshdy
- Department of Clinical Pharmacy, Faculty of Pharmacy, Beni-Suef University, Beni Suef, Egypt.,Department of Clinical Pharmacy, Faculty of Pharmacy, Modern University for Technology and Information, Cairo, Egypt
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24
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Hippo signaling pathway and respiratory diseases. Cell Death Dis 2022; 8:213. [PMID: 35443749 PMCID: PMC9021242 DOI: 10.1038/s41420-022-01020-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 04/06/2022] [Accepted: 04/07/2022] [Indexed: 12/16/2022]
Abstract
The hippo signaling pathway is a highly conserved evolutionary signaling pathway that plays an important role in regulating cell proliferation, organ size, tissue development, and regeneration. Increasing evidences consider that the hippo signaling pathway is involved in the process of respiratory diseases. Hippo signaling pathway is mainly composed of mammalian STE20-like kinase 1/2 (MST1/2), large tumor suppressor 1/2 (LATS1/2), WW domain of the Sav family containing protein 1 (SAV1), MOB kinase activator 1 (MOB1), Yes-associated protein (YAP) or transcriptional coactivator with PDZ-binding motif (TAZ), and members of the TEA domain (TEAD) family. YAP is the cascade effector of the hippo signaling pathway. The activation of YAP promotes pulmonary arterial vascular smooth muscle cells (PAVSMCs) proliferation, which leads to pulmonary vascular remodeling; thereby the pulmonary arterial hypertension (PAH) is aggravated. While the loss of YAP leads to high expression of inflammatory genes and the accumulation of inflammatory cells, the pneumonia is consequently exacerbated. In addition, overexpressed YAP promotes the proliferation of lung fibroblasts and collagen deposition; thereby the idiopathic pulmonary fibrosis (IPF) is promoted. Moreover, YAP knockout reduces collagen deposition and the senescence of adult alveolar epithelial cells (AECs); hence the IPF is slowed. In addition, hippo signaling pathway may be involved in the repair of acute lung injury (ALI) by promoting the proliferation and differentiation of lung epithelial progenitor cells and intervening in the repair of pulmonary capillary endothelium. Moreover, the hippo signaling pathway is involved in asthma. In conclusion, the hippo signaling pathway is involved in respiratory diseases. More researches are needed to focus on the molecular mechanisms by which the hippo signaling pathway participates in respiratory diseases.
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25
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Ahmad A. Pharmacological Strategies and Recent Advancement in Nano-Drug Delivery for Targeting Asthma. Life (Basel) 2022; 12:life12040596. [PMID: 35455087 PMCID: PMC9032250 DOI: 10.3390/life12040596] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 04/08/2022] [Accepted: 04/15/2022] [Indexed: 12/22/2022] Open
Abstract
With a high prevalence globally, asthma is a severe hazard to human health, as well as an economic and social burden. There are now novel therapies available for asthma with the use of nanotechnology. Recent developments in nanoscience and medicine have encouraged the creation of inhalable nanomedicines that can enhance the efficacy, patient compliance, and life quality for sufferers of asthma. Nanocarriers for asthma therapy, including liposomes, micelles, polymers, dendrimers, and inorganics, are presented in depth in this study as well as the current research status of these nanocarriers. Aerosolized nanomaterial-based drug transport systems are currently being developed, and some examples of these systems, as well as prospective future paths, are discussed. New research subjects include nano-modification of medicines and the development of innovative nano-drugs. Clinical experiments have proven that nanocarriers are both safe and effective. Before nanotherapy can be applied in clinical practice, several obstacles must be addressed. We look at some of the most recent research discoveries in the subject of nanotechnology and asthma therapy in this article.
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Affiliation(s)
- Aftab Ahmad
- Health Information Technology Department, Faculty of Applied Studies, King Abdulaziz University, Jeddah 21589, Saudi Arabia
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26
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Afolabi T, Fairman KA. Association of Asthma Exacerbation Risk and Physician Time Expenditure With Provision of Asthma Action Plans and Education for Pediatric Patients. J Pediatr Pharmacol Ther 2022; 27:244-253. [PMID: 35350158 DOI: 10.5863/1551-6776-27.3.244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 07/14/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To provide information about factors underlying provision of asthma action plans (AAPs) to a minority of pediatric patients with asthma, assess whether risk of exacerbation acts on provision of AAP and asthma education directly, suggesting targeting to highest-risk patients, or indirectly by influencing physician-patient interaction time. METHODS This study was a retrospective cross-sectional analysis of a nationally representative sample of physician office visits that consisted of patients aged 2 to 18 years with asthma. Exacerbation risk comprised proxy indicators of control and severity. Direct and time-mediated effects of exacerbation risk on provision of AAP and education were calculated from logistic regression models. RESULTS Asthma action plans were provided in 14.3% of visits, education in 23.9%. Total direct effects of exacerbation risk (ORs = 3.88-4.69) far exceeded indirect, time-mediated effects (both ORs = 1.03) on AAPs. Direct effects on education were similar but smaller. After adjusting for risk, physician time expenditure of ≥30 minutes was associated with nearly doubled odds of providing AAP or education (ORs = 1.90-1.99). Visits that included allied health professionals alongside physician care were significantly associated with all 4 outcomes in multivariate analyses (ORs = 3.06-5.28). CONCLUSIONS Exacerbation risk has a strong, direct association with AAP provision in pediatric asthma, even controlling for physician time expenditure. Provision of AAP and education to pediatric patients with asthma may be facilitated by increasing available time for office visits and involving allied health professionals.
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Affiliation(s)
- Titilola Afolabi
- Midwestern University College of Pharmacy-Glendale (TA, KAF), Glendale, AZ.,Phoenix Children's Hospital (TA), Phoenix, AZ
| | - Kathleen A Fairman
- Midwestern University College of Pharmacy-Glendale (TA, KAF), Glendale, AZ
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27
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The Influence of the Pharmacists’ Training on the Quality and Comprehensiveness of Professional Advice Given in the Field of Inhalation Techniques in Community Pharmacies in Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042071. [PMID: 35206255 PMCID: PMC8872325 DOI: 10.3390/ijerph19042071] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 02/07/2022] [Accepted: 02/07/2022] [Indexed: 02/04/2023]
Abstract
Background: Following the example of other countries, it is very important to educate patients on the correct use of inhalers by properly trained healthcare professionals, including pharmacists. Objectives: The aim of the study was to assess the quality and comprehensiveness of professional advice given by pharmacists on the use of inhalers, which was determined by the pharmacists’ level of training. Methods: The study was conducted from June 2019 to March 2020. 150 pharmacists from Poznan and Warsaw (Poland) were involved. Before the study began, the professional education of 240 pharmacists was conducted in Warsaw to implement standard operating procedures. The study used the model of a mystery shopper. Results: The conversation with a trained pharmacist lasted on average 5.5 min, with an untrained one—3.0 min (p < 0.0001). Placebo inhalers were used more often by trained pharmacists during patients’ education (p < 0.0001). Moreover, 10.3% of untrained pharmacists did not provide any education. Additionally, untrained employees’ quality of advice was assessed on an average of 3.5 points, while trained ones—7.6 points (p < 0.0001). Conclusions: This study has shown that there is a need for professional training among pharmacists in Poland, which translates into better patient education in the field of inhalation techniques.
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28
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Visser CD, Linthorst JM, Kuipers E, Sont JK, Lacroix JPW, Guchelaar HJ, Teichert M. Respiratory Adherence Care Enhancer Questionnaire: Identifying Self-Management Barriers of Inhalation Corticosteroids in Asthma. Front Pharmacol 2022; 12:767092. [PMID: 35002706 PMCID: PMC8729223 DOI: 10.3389/fphar.2021.767092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 11/25/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Suboptimal self-management of inhaled corticosteroids (ICS) in asthma patients is frequently observed in clinical practice and associated with poor asthma control. Driving factors for suboptimal self-management are complex and consist of a range of behavioral barriers (cognitive, affective and practical) with a considerable inter-individual variability. Identification of individual barriers facilitates the use of corresponding behavior change techniques and tailored care to improve asthma treatment outcomes. Objective: This study describes the development and validation of the 'Respiratory Adherence Care Enhancer' (RACE) questionnaire to identify individual barriers to self-management of ICS therapy in asthma patients. Methods: The development included: 1) an inventory of self-management barriers based on a literature review, 2) expert assessment on relevance and completeness of this set, linking these barriers to behavioral domains of the Theoretical Domains Framework (TDF) and 3) the formulation of corresponding questions assessing each of the barriers. A cross-sectional study was performed for validation. Primary care asthma patients were invited to fill out the RACE-questionnaire prior to a semi-structured telephonic interview as golden standard. Barriers detected from the questionnaire were compared to those mentioned in the interview. Results: The developed questionnaire is made up of 6 TDF-domains, covering 10 self-management barriers with 23 questions. For the validation 64 patients completed the questionnaire, of whom 61 patients were interviewed. Cronbach's alpha for the consistency of questions within the barriers ranged from 0.58 to 0.90. Optimal cut-off values for the presence of barriers were determined at a specificity between 67 and 92% with a sensitivity between 41 and 83%. Significant Areas Under the Receiver Operating Curves values were observed for 9 barriers with values between 0.69 and 0.86 (p-value <0.05), except for 'Knowledge of ICS medication' with an insignificant value of 0.53. Conclusion: The RACE-questionnaire yields adequate psychometric characteristics to identify individual barriers to self-management of ICS therapy in asthma patients, facilitating tailored care.
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Affiliation(s)
- Claire D Visser
- Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Leiden, Netherlands
| | - Jip M Linthorst
- Royal Dutch Pharmacists Association (KNMP), The Hague, Netherlands
| | | | - Jacob K Sont
- Department of Biomedical Data Sciences, Section Medical Decision Making, Leiden University Medical Center, Leiden, Netherlands
| | - Joyca P W Lacroix
- Department of Digital Engagement, Behavior and Cognition, Philips Research, Eindhoven, Netherlands
| | - Henk-Jan Guchelaar
- Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Leiden, Netherlands
| | - Martina Teichert
- Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Leiden, Netherlands.,Royal Dutch Pharmacists Association (KNMP), The Hague, Netherlands
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29
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Alshaya OA, Arab OO, Alhifany AA, Alhossan A, Alomar M, Alqahtani AG, Almolaiki MA, Mubarki S, Alruwaisan R, Alturaiki A, Alzuman S, Alsaqer AI, Korayem GB. Ambulatory care pharmacy in Saudi Arabia; definition, history, present, future potentials, and expected challenges. JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY 2021. [DOI: 10.1002/jac5.1577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Omar A. Alshaya
- Department of Pharmacy Practice, College of Pharmacy King Saud bin Abdulaziz University for Health Sciences Riyadh Saudi Arabia
- Pharmaceutical Care Services King Abdulaziz Medical City, Ministry of National Guard Health Affairs Riyadh Saudi Arabia
- King Abdullah International Medical Research Center Riyadh Saudi Arabia
| | - Omaima Osama Arab
- King Faisal Specialist Hospital and Research Center Riyadh Saudi Arabia
| | | | - Abdulaziz Alhossan
- Department of Clinical Pharmacy, College of Pharmacy King Saud University Riyadh Saudi Arabia
| | - Mukhtar Alomar
- Clinical Pharmacy Section, Pharmaceutical Care Services Dammam Health Network, Eastern Health Cluster Dammam Saudi Arabia
| | | | - Maha A. Almolaiki
- Pharmaceutical Care Services King Abdulaziz Medical City, Ministry of National Guard Health Affairs Riyadh Saudi Arabia
| | | | - Rana Alruwaisan
- Pharmacy Services Administration, King Fahad Medical City Riyadh Saudi Arabia
| | - Abdulrahman Alturaiki
- Department of Pharmacy Practice, College of Pharmacy King Saud bin Abdulaziz University for Health Sciences Riyadh Saudi Arabia
- Pharmaceutical Care Services King Abdulaziz Medical City, Ministry of National Guard Health Affairs Riyadh Saudi Arabia
- King Abdullah International Medical Research Center Riyadh Saudi Arabia
| | - Sitah Alzuman
- Pharmacy Services, King Khalid Eye Specialist Hospital Riyadh Saudi Arabia
| | | | - Ghazwa B. Korayem
- Department of Pharmacy Practice, College of Pharmacy Princess Nourah bint Abdulrahman University Riyadh Saudi Arabia
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30
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Mahdavi H, Esmaily H. Impact of educational intervention by community pharmacists on asthma clinical outcomes, quality of life and medication adherence: A systematic review and meta-analysis. J Clin Pharm Ther 2021; 46:1254-1262. [PMID: 33817821 DOI: 10.1111/jcpt.13419] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 03/01/2021] [Accepted: 03/12/2021] [Indexed: 01/20/2023]
Abstract
WHAT IS KNOWN AND OBJECTIVE Community pharmacists can play an important role in controlling chronic diseases. This study aimed to evaluate the effects of pharmacists' educational interventions in the community pharmacy settings on asthma control and severity, quality of life (QOL) and medication adherence. METHODS Databases PubMed, Scopus and Web of Science were searched for evidence regarding asthma severity and control, QOL, and medication adherence after pharmacists' interventions in community pharmacy settings. Twenty-one studies were eligible for qualitative and quantitative analysis. Indices and questionnaires were used in the studies, such as Asthma-related quality of life (IAQLQ), Asthma Control Test (ACT), Perceived Control of Asthma Questionnaire (PCAQ), inhaler technique (IT), Asthma Control Questionnaire (ACQ), 36-Item Short Form survey (SF-36) and peak expiratory flow rate (PEFR). The outcomes were extracted, pooled and analysed as percentages, means, standard deviations and errors, and 95% confidence intervals (CIs). RESULTS AND DISCUSSION Community pharmacists in all studies educated and followed up the asthmatic patients, addressing the outcome measures. Pharmacists underwent training courses of at least a day. Standardized mean differences for the indices were pooled as follows: IAQLQ -0.241 (95% CI, -0.362 to -0.121), ACT 0.14 (95% CI, 0.02 to 0.27), PCAQ -0.15 (95% CI, -0.28 to 0.01), IT 0.79 (95% CI, 0.05 to 1.54), ACQ -0.50 (95% CI, -0.69 to -0.30), SF-36 0.39 (95% CI, 0.16 to 0.62), PEFR 0.13 (95% CI, 0.01 to 0.26) and asthma symptoms score -0.34 (95% CI, -0.49 to -0.18). WHAT IS NEW AND CONCLUSION Pharmacists' educational interventions in community pharmacy settings could significantly improve asthma severity and control, QOL and medication adherence.
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Affiliation(s)
- Hossein Mahdavi
- Student Research Committee, Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hadi Esmaily
- Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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31
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Sveiven SN, Bookman R, Ma J, Lyden E, Hanson C, Nordgren TM. Milk Consumption and Respiratory Function in Asthma Patients: NHANES Analysis 2007-2012. Nutrients 2021; 13:1182. [PMID: 33918391 PMCID: PMC8067167 DOI: 10.3390/nu13041182] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 03/27/2021] [Accepted: 03/31/2021] [Indexed: 11/16/2022] Open
Abstract
Per the Centers for Disease Control and Prevention, asthma prevalence has steadily risen since the 1980s. Using data from the National Health and Nutrition Examination Survey (NHANES), we investigated associations between milk consumption and pulmonary function (PF). Multivariable analyses were performed, adjusted for a priori potential confounders for lung function, within the eligible total adult population (n = 11,131) and those self-reporting asthma (n = 1,542), included the following variables: milk-consumption, asthma diagnosis, forced vital capacity (FVC), FVC%-predicted (%), forced expiratory volume in one-second (FEV1), FEV1% and FEV1/FVC. Within the total population, FEV1% and FVC% were significantly associated with regular (5+ days weekly) consumption of exclusively 1% milk in the prior 30-days (β:1.81; 95% CI: [0.297, 3.325]; p = 0.020 and β:1.27; [0.16, 3.22]; p = 0.046). Among participants with asthma, varied-regular milk consumption in a lifetime was significantly associated with FVC (β:127.3; 95% CI: [13.1, 241.4]; p = 0.002) and FVC% (β:2.62; 95% CI: [0.44, 4.80]; p = 0.006). No association between milk consumption and FEV1/FVC was found, while milk-type had variable influence and significance. Taken together, we found certain milk consumption tendencies were associated with pulmonary function values among normal and asthmatic populations. These findings propound future investigations into the potential role of dairy consumption in altering lung function and asthma outcomes, with potential impact on the protection and maintenance of pulmonary health.
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Affiliation(s)
- Stefanie N. Sveiven
- Division of Biomedical Sciences, School of Medicine, University of California-Riverside, Riverside, CA 92521, USA; (S.N.S.); (R.B.)
| | - Rachel Bookman
- Division of Biomedical Sciences, School of Medicine, University of California-Riverside, Riverside, CA 92521, USA; (S.N.S.); (R.B.)
| | - Jihyun Ma
- Biostatistics Department, College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, USA; (J.M.); (E.L.)
| | - Elizabeth Lyden
- Biostatistics Department, College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, USA; (J.M.); (E.L.)
| | - Corrine Hanson
- Medical Nutrition Education Division, College of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE 68198, USA;
| | - Tara M. Nordgren
- Division of Biomedical Sciences, School of Medicine, University of California-Riverside, Riverside, CA 92521, USA; (S.N.S.); (R.B.)
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32
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Srour-Alphonse P, Cvetkovski B, Azzi E, Rand C, Cheong LHM, Kritikos V, Bosnic-Anticevich S. Understanding the Influences Behind Parents' Asthma Decision-Making: A Qualitative Exploration of the Asthma Network of Parents with Children with Asthma. Pulm Ther 2021; 7:151-170. [PMID: 33569733 PMCID: PMC8137740 DOI: 10.1007/s41030-021-00145-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 01/15/2021] [Indexed: 11/28/2022] Open
Abstract
Introduction Interventions aimed at optimizing parents’ ability to manage their children’s asthma could be strengthened by better understanding the networks that influence these parents’ choices when managing asthma. This study aimed to explore the asthma networks of parents of children with asthma—specifically to gain insights into whom parents select to be within their networks and why; how individuals within parents’ networks influence the way in which they manage their children’s asthma medications, and factors driving the development of these networks. Methods A qualitative research methodology utilizing semi-structured interviews with parents of children with asthma was employed to fulfil the objectives of this study. Results Twenty-six face-to-face interviews with parents of children with asthma were conducted, recorded, and transcribed. Transcriptions were independently coded for concepts and themes by the research team. Asthma medications was a dominant theme identified, and revealed that parents actively sought advice and support from a series of complex and multidimensional relationships with people and resources in their health network. These not only included health care professionals (HCPs) but also personal connections, lay individuals, and resources. The composition and development of these asthma networks occurred over time and were determined by several key factors: satisfaction with their HCP provider; need for information; convenience; trust and support; self-confidence in management; and parents’ perceptions of their children’s asthma severity. Conclusions By exploring parents’ asthma network, this study uncovers the complex relationship between HCPs, family and friends of parents of children with asthma, and provides new insight into the intimate and parallel influence they have on parent’s decision-making.
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Affiliation(s)
- Pamela Srour-Alphonse
- Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia. .,Woolcock Institute of Medical Research, The University of Sydney, Sydney, Australia.
| | - Biljana Cvetkovski
- Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,Woolcock Institute of Medical Research, The University of Sydney, Sydney, Australia
| | - Elizabeth Azzi
- Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,Woolcock Institute of Medical Research, The University of Sydney, Sydney, Australia
| | - Cynthia Rand
- Pulmonary and Critical Care Medicine Department, John Hopkins University, Baltimore, MD, USA
| | - Lynn H M Cheong
- Faculty of Health, University of Canberra, Canberra, Australia
| | - Vicky Kritikos
- Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,Woolcock Institute of Medical Research, The University of Sydney, Sydney, Australia.,Department of Respiratory Medicine, Royal Prince Alfred Hospital, Sydney, NSW, Australia
| | - Sinthia Bosnic-Anticevich
- Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,Woolcock Institute of Medical Research, The University of Sydney, Sydney, Australia.,Central Sydney Local Area Health District, Sydney, Australia
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