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Pharmacist-initiated general practitioner referral of patients with suboptimal asthma management

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Bereznicki, BJ and Peterson, GM and Jackson, SL and Walters, EH and Fitzmaurice, KD and Gee, PR (2008) Pharmacist-initiated general practitioner referral of patients with suboptimal asthma management. Pharmacy World and Science, 30 (6). pp. 1-7. ISSN 0928-1231

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Abstract

Objective To assess the impact of an intervention initiated by community pharmacists, involving the provision of educational material and general practitioner (GP) referral, on asthma knowledge and self-reported asthma control and asthma-related quality of life (QOL) in patients who may have suboptimal management of their asthma, as evidenced by pharmacy dispensing records. Setting Community pharmacies throughout Tasmania, Australia. Methods Forty-two pharmacies installed a software application that data mined dispensing records and generated a list of patients with suboptimal asthma management, as indicated by having three or more canisters of inhaled short-acting beta-2-agonists dispensed in the preceding 6 months. Identified patients were randomised to an intervention or control group. At baseline, intervention patients were mailed intervention packs consisting of a letter encouraging them to see their GP for a review, educational material, asthma knowledge, asthma control and asthma-related QOL questionnaires, and a letter with a dispensing history to give to their GP. Pharmacists were blinded to the control patients’ identities for 6 months, after which time intervention patients were sent repeat questionnaires, and control patients were sent intervention packs. Main outcome measures Asthma knowledge, asthma control and asthma-related QOL scores. Results Thirty-five pharmacies completed the study, providing 706 intervention and 427 control patients who were eligible to receive intervention packs. Intervention patients’ asthma control and asthma-related QOL scores at 6 months were significantly higher compared to the control patients (P < 0.01 and P < 0.05, respectively) and to the intervention patients’ baseline scores (P < 0.001 and P < 0.05, respectively). Symptom-related QOL was significantly higher compared to the control patients (P < 0.01) and activities-related QOL significantly improved compared to baseline (P < 0.05). No significant change was observed in asthma knowledge. Conclusion The results suggest that community pharmacists are ideally placed to identify patients with suboptimal asthma management and refer such patients for a review by their GP. This type of collaborative intervention can significantly improve self-reported asthma control and asthma-related QOL in patients identified as having suboptimal management of their asthma. A larger trial is needed to confirm the effects are real and sustained.

Item Type: Article
Keywords: Asthma - Australia - Data mining - General practitioner - Intervention study - Patient referral - Pharmacy - Quality of life
Journal or Publication Title: Pharmacy World and Science
Page Range: pp. 1-7
ISSN: 0928-1231
Identification Number - DOI: 10.1007/s11096-008-9242-3
Additional Information: The original publication is available at www.springerlink.com
Date Deposited: 12 Nov 2008 21:41
Last Modified: 18 Nov 2014 03:53
URI: http://eprints.utas.edu.au/id/eprint/7975
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