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Sykes DL, See YY, Chow ECY, Crooks MG, Cummings H, Robinson M, Watkins K, Thompson J, Overton K, Riches C, Faruqi S. Digitally monitored inhaled therapy: a 'smart' way to manage severe asthma? J Asthma 2024; 61:970-975. [PMID: 38323583 DOI: 10.1080/02770903.2024.2316726] [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: 12/06/2023] [Revised: 01/12/2024] [Accepted: 02/05/2024] [Indexed: 02/08/2024]
Abstract
INTRODUCTION One of the fundamental challenges of managing patients with severe asthma is treatment adherence, particularly with inhaled corticosteroids. Adherence is difficult to measure objectively and poor adherence is associated with worse outcomes. In this study, assess the ability of a 'smart' inhaler to record adherence in severe asthma patients and measure the impact of this on asthma control. METHODS Consecutive consenting patients meeting criteria for biologics had their existing high-dose ICS/LABA//LAMA combination inhaler/s switched to mometasone/indacaterol/glycopyrronium (114/46/136). Routine clinical data, including blood eosinophils, FeNO, and ACQ-6 scores were collected at baseline and at 4 wk. Adherence was then checked on the Propeller Health app, and good adherence was defined as >80% of prescribed usage. Participants were then followed-up at 12 months to record the proportion of patients who were initiated on biologics. RESULTS 77 patients (mean [SD] age = 50.4 [15.7] years, 67.5% female [n = 52]) participated. 71 participants were able to use the device and 65% (n = 46) of these attained good asthma control and were not initiated on biologics at 12-month follow-up. Both groups demonstrated a significant reduction in ACQ6 score at follow-up (2.81 vs. 1.92, p < 0.001 and 3.05 vs. 2.60, p < 0.001, respectively), but there was no statistically significant difference in improvement between groups. Patients with optimal adherence also demonstrated a significant reduction in median FeNO at follow-up (47 ppb vs. 40 ppb, p = 0.003). CONCLUSIONS In severe asthma patients, 'smart' inhalers may represent an effective management tool to improve adherence and asthma control, therefore avoiding the need for patients to commence biological therapies.
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Affiliation(s)
- Dominic L Sykes
- Respiratory Research Group, Hull York Medical School, Heslington, UK
- Department of Respiratory Medicine, Hull University Teaching Hospitals NHS Trust, Cottingham, UK
| | - Yee Yong See
- Department of Respiratory Medicine, Hull University Teaching Hospitals NHS Trust, Cottingham, UK
| | - Evon C Y Chow
- Department of Respiratory Medicine, Hull University Teaching Hospitals NHS Trust, Cottingham, UK
| | - Michael G Crooks
- Respiratory Research Group, Hull York Medical School, Heslington, UK
- Department of Respiratory Medicine, Hull University Teaching Hospitals NHS Trust, Cottingham, UK
| | | | - Mandy Robinson
- Department of Respiratory Medicine, Hull University Teaching Hospitals NHS Trust, Cottingham, UK
| | - Karen Watkins
- Department of Respiratory Medicine, Hull University Teaching Hospitals NHS Trust, Cottingham, UK
| | - Joanne Thompson
- Department of Respiratory Medicine, Hull University Teaching Hospitals NHS Trust, Cottingham, UK
| | - Kylie Overton
- Department of Respiratory Medicine, Hull University Teaching Hospitals NHS Trust, Cottingham, UK
| | - Charlotte Riches
- Department of Respiratory Medicine, Hull University Teaching Hospitals NHS Trust, Cottingham, UK
| | - Shoaib Faruqi
- Respiratory Research Group, Hull York Medical School, Heslington, UK
- Department of Respiratory Medicine, Hull University Teaching Hospitals NHS Trust, Cottingham, UK
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Oppenheimer J, Bender B, Sousa-Pinto B, Portnoy J. Use of Technology to Improve Adherence in Allergy/Immunology. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2024:S2213-2198(24)00749-9. [PMID: 39074604 DOI: 10.1016/j.jaip.2024.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Revised: 07/14/2024] [Accepted: 07/15/2024] [Indexed: 07/31/2024]
Abstract
The integration of technology into health care has shown significant promise in enhancing patient adherence, particularly in the field of allergy/immunology. This article explores the multifaceted approaches through which digital health interventions can be used to improve adherence rates among patients with allergic diseases and immunologic disorders. By reviewing recent advancements in telemedicine, mobile health applications, wearable devices, and digital reminders, as well as smart inhalers, we aim to provide a comprehensive overview of how these technologies can support patients in managing their conditions. The analysis highlights the role of personalized digital health plans, which, through the use of artificial intelligence and machine learning algorithms, can offer tailored advice, monitor symptoms, and adjust treatment protocols in real time. Moreover, the article discusses the impact of electronic health records and patient portals in fostering a collaborative patient-provider relationship, thereby enhancing communication and adherence. The integration of these technologies has been shown to not only improve clinical outcomes but also increase patient satisfaction and engagement.
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Affiliation(s)
| | - Bruce Bender
- Center for Health Promotion, National Jewish Health, Denver, Colo
| | - Bernardo Sousa-Pinto
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
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3
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Kardas P. From non-adherence to adherence: Can innovative solutions resolve a longstanding problem? Eur J Intern Med 2024; 119:6-12. [PMID: 37848351 DOI: 10.1016/j.ejim.2023.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 10/06/2023] [Accepted: 10/12/2023] [Indexed: 10/19/2023]
Abstract
Non-adherence to medication is a longstanding problem, profoundly affecting patient outcomes and sustainability of healthcare systems. Historically, non-adherence has been observed since the time of Hippocrates, however, when potent drugs became available in the midst of the 20th century, it became a pivotal concern. Despite numerous studies and interventions designed, medication adherence rates remain suboptimal, currently reaching about 50 % still, as described in WHO report two decades ago. What is worse, many healthcare professionals feel neither responsible nor able to change it. Enhancing adherence requires in-depth understanding of the concept, as many intuitive approaches fail to work. For example, contrary to expectations, patient education alone proves insufficient when addressing this issue. Both behavioural models and recent experience reflecting low acceptance of COVID-19 vaccinations strongly suggest that patients' decisions are driven by emotions, which often results in intentional non-adherence. Several technical innovations, such as smart inhalers and electronic pill dispensers, offer potential solutions. However, their effectiveness varies, and standardized certification procedures are lacking. Altogether, technical solutions do not eliminate the problem entirely. To move forward, social and health system innovation is equally needed. Multiple stakeholders could benefit from improved adherence, therefore their greater involvement is advisable to create an adherence-supporting environment. In conclusion, despite available evidence-based interventions, non-adherence remains a complex challenge. Technical and social innovations, combined with a shift in policy priorities, could lead to improved medication adherence and better patient outcomes. The global tide of non-communicable chronic conditions, and aging of societies urges us to take this problem seriously.
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Affiliation(s)
- Przemyslaw Kardas
- Medication Adherence Research Center, Department of Family Medicine, Medical University of Lodz, Lodz, Poland
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4
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Kouri A, Wong EKC, Sale JEM, Straus SE, Gupta S. Are older adults considered in asthma and chronic obstructive pulmonary disease mobile health research? A scoping review. Age Ageing 2023; 52:afad144. [PMID: 37742283 DOI: 10.1093/ageing/afad144] [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: 12/06/2022] [Indexed: 09/26/2023] Open
Abstract
BACKGROUND The use of mobile health (mHealth) for asthma and chronic obstructive pulmonary disease (COPD) is rapidly growing and may help address the complex respiratory care needs of our ageing population. However, little is currently known about how airways mHealth is developed and used among older adults (≥65 years). OBJECTIVE To identify if and how older adults with asthma and COPD have been incorporated across the mHealth research cycle. METHODS We searched Ovid MEDLINE, EMBASE, CINAHL and the Cochrane Central Registry of Controlled Trials for studies pertaining to the development or evaluation of asthma and COPD mHealth for adults published after 2010. Study, participant and mHealth details, including any considerations of older age, were extracted, synthesised and charted. RESULTS A total of 334 studies of 191 mHealth tools were identified. Adults ≥65 years old were included in 33.3% of asthma mHealth studies and 85.3% of COPD studies. Discussions of older age focused on barriers to technology use. Methodologic and/or analytic considerations of older age were mostly absent throughout the research cycle. Among the 28 instances quantitative age-related analyses were detailed, 12 described positive mHealth use and satisfaction outcomes in older adults versus negative or equivocal outcomes. CONCLUSION We identified an overall lack of consideration for older age throughout the airways mHealth research cycle, even among COPD mHealth studies that predominantly included older adults. We also found a contrast between the perceptions of how older age might negatively influence mHealth use and available quantitative evaluations. Future airways mHealth research must better integrate the needs and concerns of older adults.
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Affiliation(s)
- Andrew Kouri
- Department of Medicine, Division of Respirology, Women's College Hospital, Toronto, ON, Canada
| | - Eric K C Wong
- Department of Medicine, Division of Geriatric Medicine, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Joanna E M Sale
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Sharon E Straus
- Department of Medicine, Division of Geriatric Medicine, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Samir Gupta
- Department of Medicine, Division of Respirology, Women's College Hospital, Toronto, ON, Canada
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
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5
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Gul S, Rehman IU, Goh KW, Ali Z, Rahman AU, Khalil A, Shah I, Khan TM, Ming LC. Can Pharmacists' Counseling Improve the Use of Inhalers and Quality of Life? A Prospective "Pre" and "Post" Education Analysis in Mardan, Pakistan. J Asthma Allergy 2023; 16:679-687. [PMID: 37435420 PMCID: PMC10332412 DOI: 10.2147/jaa.s405943] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 05/05/2023] [Indexed: 07/13/2023] Open
Abstract
Introduction Asthma is one of the common major non-communicable respiratory diseases, and is associated with a lower health-related quality of life (QOL). Poor inhalation is a significant contributing factor to poor control of asthma. Community pharmacist has a vital role to play in assisting patients and ultimately improving their asthma conditions through the use of inhalers. Aim This study aimed to assess the effectiveness of "pre" and "post" educational intervention by a community pharmacist within a community pharmacy on asthma patients' QOL, inhaler technique, and adherence to therapy during the endemic phase of COVID-19. Methods A "pre" and "post" interventional study was performed at a community pharmacy in the city of Mardan, Pakistan, in 2022 during the COVID-19 pandemic. Patients were divided into two groups, ie control and pharmacist-led education groups. After assigning patients to both groups, the baseline data were collected and followed for one month to compare the reduction in errors in the use of inhalers, QOL, and adherence to therapy. A paired sample t-test was performed, keeping a p-value <0.05 as statistical significance. Results A total of 60 patients were recruited, majority (58.3%) were females, and 28.3% were from the age group of 46-55 years old. A statistically significant difference was observed in the pre- and post-education QOL score among patients in the pharmacist-led education group, from a mean ± SD at pre-education of 40.23±10.03 to a mean±SD at post-education of 48.10±5.68. Similarly, a statistically significant difference was observed for the correct use of inhalers, ie MDIs and DPIs. Similarly, a statistically significant difference was observed in the adherence status between pre-education and post-education by pharmacists. Conclusion The findings of the study revealed a positive impact of community pharmacist-led education on QOL, inhaler technique, and adherence to therapy among patients with asthma.
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Affiliation(s)
- Sumaira Gul
- Department of Pharmacy, Garden Campus, Abdul Wali Khan University Mardan, Khyber Pakhtunkhwa, Pakistan
| | - Inayat Ur Rehman
- Department of Pharmacy, Garden Campus, Abdul Wali Khan University Mardan, Khyber Pakhtunkhwa, Pakistan
| | - Khang Wen Goh
- Faculty of Data Science and Information Technology, INTI International University, Nilai, Malaysia
| | - Zahid Ali
- Department of Pharmacy, University of Peshawar, Peshawar, Pakistan
| | - Aziz Ur Rahman
- Department of Urology, North West General Hospital and Research Center Peshawar, Peshawar, Pakistan
| | - Asad Khalil
- Department of Medicine, Lady Reading Hospital, Peshawar, Pakistan
| | - Ismail Shah
- Department of Pharmacy, Garden Campus, Abdul Wali Khan University Mardan, Khyber Pakhtunkhwa, Pakistan
| | - Tahir Mehmood Khan
- Institute of Pharmaceutical Sciences, University of Veterinary and Animal Sciences Lahore, Lahore, Pakistan
| | - Long Chiau Ming
- PAP Rashidah Sa’adatul Bolkiah Institute of Health Sciences, Universiti Brunei Darussalam, Gadong, Brunei Darussalam
- School of Medical and Life Sciences, Sunway University, Sunway City, Malaysia
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6
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Cachim A, Pereira AM, Almeida R, Amaral R, Alves‐Correia M, Vieira‐Marques P, Chaves‐Loureiro C, Ribeiro C, Cardia F, Gomes J, Vidal C, Silva E, Rocha S, Rocha D, Marques ML, Páscoa R, Morais D, Cruz AM, Santalha M, Simões JA, da Silva S, Silva D, Gerardo R, Todo Bom F, Morete A, Vieira I, Vieira P, Monteiro R, Raimundo MR, Monteiro L, Neves Â, Santos C, Penas AM, Regadas R, Marques JV, Rosendo I, Aguiar MA, Fernandes S, Cardoso CS, Pimenta F, Meireles P, Gonçalves M, Fonseca JA, Jácome C. Measuring adherence to inhaled control medication in patients with asthma: Comparison among an asthma app, patient self-report and physician assessment. Clin Transl Allergy 2023; 13:e12210. [PMID: 36825517 PMCID: PMC9930432 DOI: 10.1002/clt2.12210] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 08/27/2022] [Accepted: 09/30/2022] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND Previous studies have demonstrated the feasibility of using an asthma app to support medication management and adherence but failed to compare with other measures currently used in clinical practice. However, in a clinical setting, any additional adherence measurement must be evaluated in the context of both the patient and physician perspectives so that it can also help improve the process of shared decision making. Thus, we aimed to compare different measures of adherence to asthma control inhalers in clinical practice, namely through an app, patient self-report and physician assessment. METHODS This study is a secondary analysis of three prospective multicentre observational studies with patients (≥13 years old) with persistent asthma recruited from 61 primary and secondary care centres in Portugal. Patients were invited to use the InspirerMundi app and register their inhaled medication. Adherence was measured by the app as the number of doses taken divided by the number of doses scheduled each day and two time points were considered for analysis: 1-week and 1-month. At baseline, patients and physicians independently assessed adherence to asthma control inhalers during the previous week using a Visual Analogue Scale (VAS 0-100). RESULTS A total of 193 patients (72% female; median [P25-P75] age 28 [19-41] years old) were included in the analysis. Adherence measured by the app was lower (1 week: 31 [0-71]%; 1 month: 18 [0-48]%) than patient self-report (80 [60-95]) and physician assessment (82 [51-94]) (p < 0.001). A negligible non-significant correlation was found between the app and subjective measurements (ρ 0.118-0.156, p > 0.05). There was a moderate correlation between patient self-report and physician assessment (ρ = 0.596, p < 0.001). CONCLUSIONS Adherence measured by the app was lower than that reported by the patient or the physician. This was expected as objective measurements are commonly lower than subjective evaluations, which tend to overestimate adherence. Nevertheless, the low adherence measured by the app may also be influenced by the use of the app itself and this needs to be considered in future studies.
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Affiliation(s)
| | - Ana Margarida Pereira
- Center for Health Technology and Services Research (CINTESIS)Faculty of MedicineUniversity of PortoPortoPortugal,Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS)Faculty of MedicineUniversity of PortoPortoPortugal,Allergy UnitInstituto and Hospital CUF‐PortoPortoPortugal
| | - Rute Almeida
- Center for Health Technology and Services Research (CINTESIS)Faculty of MedicineUniversity of PortoPortoPortugal,Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS)Faculty of MedicineUniversity of PortoPortoPortugal
| | - Rita Amaral
- Center for Health Technology and Services Research (CINTESIS)Faculty of MedicineUniversity of PortoPortoPortugal,Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS)Faculty of MedicineUniversity of PortoPortoPortugal,Department of Cardiovascular and Respiratory SciencesPorto Health SchoolPolytechnic Institute of PortoPortoPortugal,Department of Women's and Children's HealthPediatric ResearchUppsala UniversityUppsalaSweden
| | - Magna Alves‐Correia
- Center for Health Technology and Services Research (CINTESIS)Faculty of MedicineUniversity of PortoPortoPortugal,Allergy UnitInstituto and Hospital CUF‐PortoPortoPortugal
| | - Pedro Vieira‐Marques
- Center for Health Technology and Services Research (CINTESIS)Faculty of MedicineUniversity of PortoPortoPortugal
| | - Claudia Chaves‐Loureiro
- Pulmonology DepartmentHospitais da Universidade de CoimbraCentro Hospitalar e Universitário de CoimbraCoimbraPortugal,Clinical Academic Center of CoimbraCoimbraPortugal
| | - Carmelita Ribeiro
- Serviço ImunoalergologiaCentro Hospitalar e Universitário de CoimbraCoimbraPortugal
| | - Francisca Cardia
- Unidade de Saúde Familiar (USF) Terras de AzuraraAgrupamento de Centros de Saúde Dão LafõesMangualdePortugal
| | - Joana Gomes
- Serviço de Imunoalergologia, Unidade ICentro Hospitalar Vila Nova de Gaia/EspinhoVila Nova de GaiaPortugal
| | - Carmen Vidal
- Servicio de AlergiaComplejo Hospitalario Universitario de SantiagoSantiago de CompostelaSpain
| | - Eurico Silva
- USF João SemanaAgrupamento de Centros de Saúde (ACES) Baixo VougaOvarPortugal
| | - Sara Rocha
- USF Arte NovaACES Baixo VougaOliveirinhaPortugal
| | - Diana Rocha
- USF Sá de MirandaACES Cávado II ‐ Gerês/CabreiraVila VerdePortugal
| | - Maria Luís Marques
- Serviço de ImunoalergologiaHospital da Senhora da OliveiraGuimarãesPortugal
| | - Rosália Páscoa
- Center for Health Technology and Services Research (CINTESIS)Faculty of MedicineUniversity of PortoPortoPortugal,Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS)Faculty of MedicineUniversity of PortoPortoPortugal,USF Abel SalazarACES GaiaVila Nova de GaiaPortugal
| | - Daniela Morais
- USF CorgoACES Douro I ‐ Marão e Douro NorteVila RealPortugal
| | | | - Marta Santalha
- Serviço de PediatriaHospital da Senhora da OliveiraGuimarãesPortugal
| | - José Augusto Simões
- Center for Health Technology and Services Research (CINTESIS)Faculty of MedicineUniversity of PortoPortoPortugal,USF Caminhos do CértomaACES Baixo MondegoPampilhosaPortugal,Department of Medical SciencesUniversity of Beira InteriorCovilhãPortugal
| | - Sofia da Silva
- USF CuidarteUnidade Local de Saúde do Alto MinhoPortuzeloPortugal
| | - Diana Silva
- Faculty of MedicineUniversity of PortoPortoPortugal,Serviço de ImunoalergologiaCentro Hospitalar Universitário de São JoãoPortoPortugal
| | - Rita Gerardo
- Serviço de PneumologiaHospital Santa MartaCentro Hospitalar Universitário de Lisboa CentralLisboaPortugal
| | | | - Ana Morete
- Allergy UnitInstituto and Hospital CUF‐PortoPortoPortugal,Serviço de ImunoalergologiaHospital Infante D PedroCentro Hospitalar Baixo VougaAveiroPortugal
| | - Inês Vieira
- Unidade de Cuidados Saúde Personalizados Arnaldo SampaioACES Pinhal LitoralLeiriaPortugal
| | | | - Rosário Monteiro
- Center for Health Technology and Services Research (CINTESIS)Faculty of MedicineUniversity of PortoPortoPortugal,Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS)Faculty of MedicineUniversity of PortoPortoPortugal,USF Homem do LemeACES Porto OcidentalPortoPortugal
| | | | - Luís Monteiro
- Center for Health Technology and Services Research (CINTESIS)Faculty of MedicineUniversity of PortoPortoPortugal,USF Esgueira+ACES Baixo VougaEsgueiraPortugal
| | | | - Carlos Santos
- USF Santo AntónioACES Cávado III ‐ Barcelos/EsposendeBarcelosPortugal
| | | | - Rita Regadas
- USF Aquilino RibeiroACES Douro II ‐ Douro SulMoimenta da BeiraPortugal
| | | | - Inês Rosendo
- Center for Health Technology and Services Research (CINTESIS)Faculty of MedicineUniversity of PortoPortoPortugal,USF Coimbra CentroACES Baixo MondegoCoimbraPortugal
| | | | - Sara Fernandes
- UCSP São João da PesqueiraACES Douro SulSão João da PesqueiraPortugal
| | - Carlos Seiça Cardoso
- Center for Health Technology and Services Research (CINTESIS)Faculty of MedicineUniversity of PortoPortoPortugal,USF CondeixaACES Baixo MondegoCondeixa‐a‐NovaPortugal
| | | | | | | | - João Almeida Fonseca
- Center for Health Technology and Services Research (CINTESIS)Faculty of MedicineUniversity of PortoPortoPortugal,Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS)Faculty of MedicineUniversity of PortoPortoPortugal,Allergy UnitInstituto and Hospital CUF‐PortoPortoPortugal,MEDIDA – Medicina, Educação, Investigação, Desenvolvimento e AvaliaçãoPortoPortugal
| | - Cristina Jácome
- Center for Health Technology and Services Research (CINTESIS)Faculty of MedicineUniversity of PortoPortoPortugal,Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS)Faculty of MedicineUniversity of PortoPortoPortugal
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7
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Improving Asthma Management: Patient–Pharmacist Partnership Program in Enhancing Therapy Adherence. PHARMACY 2022; 10:pharmacy10010034. [PMID: 35202083 PMCID: PMC8878305 DOI: 10.3390/pharmacy10010034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 02/04/2022] [Accepted: 02/08/2022] [Indexed: 01/27/2023] Open
Abstract
Community pharmacist interventions can assist in improving adherence in patients with asthma. The objective of the study was to assess the feasibility of patient-centered counseling using the developed asthma-specific tools to identify barriers to adherence and identify their preliminary effect on adherence barrier score and asthma control. Adult patients with persistent asthma were invited to participate in a 3-month pre–post intervention study involving community pharmacist-provided patient-centered counseling. Bivariate analyses were conducted to determine whether there were changes in outcomes from the pre to post period. Of 36 recruited patients, 17 completed both pre and post surveys. At baseline, patients had a mean ACT score of 15.1 ± 3.5, with 94% having uncontrolled asthma, and an average of 4.2 ± 2.5 reported barriers. The following barriers were most common: not having an Asthma Action Plan (52.9%), use of inhaler more or less often than prescribed (47.1%) and forgetfulness (41.2%). The ACT score increased by 2.7 ± 5.4, which was not statistically significant; however, it might be clinically significant. Two barrier scores improved as a result of the intervention. Preliminary evidence on the feasibility of identifying and addressing patient-specific barriers to adherence delivered by pharmacists showed that it has the potential to resolve barriers and improve asthma outcomes.
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