Effect of an educational intervention delivered by pharmacists on adherence to treatment, disease control and lung function in patients with asthma.


Journal

Respiratory medicine
ISSN: 1532-3064
Titre abrégé: Respir Med
Pays: England
ID NLM: 8908438

Informations de publication

Date de publication:
Historique:
received: 24 08 2020
revised: 03 10 2020
accepted: 19 10 2020
pubmed: 30 10 2020
medline: 22 6 2021
entrez: 29 10 2020
Statut: ppublish

Résumé

Lack of therapeutic adherence is a relevant problem in clinical practice and it can be assessed via validated tools such as the Test of Adherence to Inhalers (TAI). Education on the correct use of inhaler devices has been associated with improvement in adherence. Many studies highlighted the pivotal role of pharmacists in promoting therapeutic adherence in the management of respiratory diseases. To evaluate the effectiveness on adherence and clinical parameters of an educational intervention administered by clinical pharmacists (CPs) to patients with asthma on long-term inhalation therapy. A prospective comparative study involving 34 community pharmacies in Italy (23 intervention, 11 control). Enrolled subjects were evaluated for adherence to inhalation therapy by TAI, asthma control by "Asthma Control Test" (ACT), and lung function at baseline and after 2 months. The educational intervention at baseline was based on TAI results and administered by specifically trained pharmacists. A total of 242 consecutive subjects (167 intervention, 75 control) were enrolled. There was a significant improvement in TAI score, ACT and lung function parameters (p-value<0.001) in the intervention group between baseline and the follow-up visit. Patients with baseline ACT≥20 maintained disease control more frequently in the intervention group compared to the control arm (95% vs 79.5%, p = 0.004). Conclusions through administration of TAI-driven educational interventions addressing both technical and psychological issues, trained CPs can help improve adherence to treatment and asthma control.

Sections du résumé

BACKGROUND
Lack of therapeutic adherence is a relevant problem in clinical practice and it can be assessed via validated tools such as the Test of Adherence to Inhalers (TAI). Education on the correct use of inhaler devices has been associated with improvement in adherence. Many studies highlighted the pivotal role of pharmacists in promoting therapeutic adherence in the management of respiratory diseases.
OBJECTIVE
To evaluate the effectiveness on adherence and clinical parameters of an educational intervention administered by clinical pharmacists (CPs) to patients with asthma on long-term inhalation therapy.
METHODS
A prospective comparative study involving 34 community pharmacies in Italy (23 intervention, 11 control). Enrolled subjects were evaluated for adherence to inhalation therapy by TAI, asthma control by "Asthma Control Test" (ACT), and lung function at baseline and after 2 months. The educational intervention at baseline was based on TAI results and administered by specifically trained pharmacists.
RESULTS
A total of 242 consecutive subjects (167 intervention, 75 control) were enrolled. There was a significant improvement in TAI score, ACT and lung function parameters (p-value<0.001) in the intervention group between baseline and the follow-up visit. Patients with baseline ACT≥20 maintained disease control more frequently in the intervention group compared to the control arm (95% vs 79.5%, p = 0.004). Conclusions through administration of TAI-driven educational interventions addressing both technical and psychological issues, trained CPs can help improve adherence to treatment and asthma control.

Identifiants

pubmed: 33120195
pii: S0954-6111(20)30339-5
doi: 10.1016/j.rmed.2020.106199
pii:
doi:

Substances chimiques

Anti-Asthmatic Agents 0

Types de publication

Comparative Study Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

106199

Investigateurs

Carlotta Comar (C)
Katia Vaiarelli (K)
Giuliana Gioiella (G)
Carlo Aprile (C)
Angelo Basile (A)
Anna Battisti (A)
Camilla Cavalli (C)
Mario Cirino (M)
Mirka Dalla Bella (MD)
Rita Demontis (R)
Gaetano Di Donato (G)
Rita Di Gangi (R)
Antonio Esposito (A)
Gyada Falanga (G)
Patrizia Ghetti (P)
Giuseppe Fimiani (G)
Alessia Florio (A)
Enrico Floris (E)
Alessandro Fontanesi (A)
Antonino Giuffrida (A)
Carmelo Guccione (C)
Laura Lancia (L)
Anna Maria Lanzoni (AM)
Azzurra Leo (A)
Chiara Leone (C)
Paolo Levantino (P)
Matteo Marchionni (M)
Maria Miccichè (M)
Francesco Moneghini (F)
Pia Policicchio (P)
Antonio Rauseo (A)
Flora Romano (F)
Maria Josè Sequenza (MJ)
Stefania Stabile (S)
Matilde Zacchia (M)
Stefano Iellousheg Zanetti (SI)

Informations de copyright

Copyright © 2020 Elsevier Ltd. All rights reserved.

Auteurs

Giovanni Paoletti (G)

Personalized Medicine, Asthma and Allergy, Humanitas Clinical and Research Center IRCCS, Rozzano, MI, Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, MI, Italy.

Enrico Keber (E)

Società Italiana Farmacia Clinica (SIFAC), Cagliari, Italy.

Enrico Heffler (E)

Personalized Medicine, Asthma and Allergy, Humanitas Clinical and Research Center IRCCS, Rozzano, MI, Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, MI, Italy. Electronic address: enrico.heffler@hunimed.eu.

Giacomo Malipiero (G)

Personalized Medicine, Asthma and Allergy, Humanitas Clinical and Research Center IRCCS, Rozzano, MI, Italy.

Ilaria Baiardini (I)

Personalized Medicine, Asthma and Allergy, Humanitas Clinical and Research Center IRCCS, Rozzano, MI, Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, MI, Italy.

Giorgio Walter Canonica (GW)

Personalized Medicine, Asthma and Allergy, Humanitas Clinical and Research Center IRCCS, Rozzano, MI, Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, MI, Italy.

Corrado Giua (C)

Società Italiana Farmacia Clinica (SIFAC), Cagliari, Italy.

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