Evaluating the Feasibility of a Community Pharmacy-Delivered Behaviour Change Intervention to Reduce Reliever Reliance in Asthma.

The aim of this study was to evaluate the feasibility of a community pharmacy-delivered intervention to shift patients' beliefs about short-acting beta This non-randomized, before-and-after feasibility study enrolled participants with asthma from four community pharmacies in Auckland, New Zealand. Eligible participants were aged 18 years and above and were prescribed a SABA for their asthma. The intervention included the SABA reliance questionnaire to determine the degree of SABA reliance, verbal discussions with pharmacists personalised according to the degree of SABA reliance identified, and referral to general practitioners as appropriate. Of the 44 patients who consented into the study, 19 were in the control group and 16 in the intervention group. Recruitment and retention were modest, with 10 control and five intervention participants completing the 90-day follow-up. Although not statistically significant, preliminary results indicated reduced SABA reliance and increased ICS adherence in the intervention group, and reduced SABA refill. Feedback showed that 78% of intervention participants found the information easy to understand, and 56% expressed intent to consult their general practitioners. Pharmacy staff found the intervention feasible but noted time constraints as a barrier to intervention delivery. The study demonstrates that a community pharmacy-delivered intervention is feasible and acceptable to both patients and pharmacists. While preliminary results show a positive effect on reducing SABA reliance and improvement of ICS adherence, the results were not statistically significant due to the small numbers recruited. This suggests a larger randomised trial is indicated. This intervention holds promise for addressing the over-reliance on SABA in asthma management and improving adherence to preventive therapies.

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© 2024 Foot et al.

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Dr Holly Foot: Freelance consultant for UCL-business company Spoonful of Sugar Ltd. Dr Kebede Beyene: Currently a guest editor for the Patient Preference and Adherence journal and reports grants from HRC 23/181, grants from HRC 21/867, and grants from HRC 21/056. Associate Professor Jeff Harrison: Personal fees and non-financial support from Enigma Solutions Ltd. and grants from Health Research Council of New Zealand, outside the submitted work. Dr James Fingleton: Grants, personal fees and non-financial support from AstraZeneca, GlaxoSmithKline and Boehringer Ingelheim; grants from Genentech, outside the submitted work. Professor Rob Horne: Grants/research support AstraZeneca; National Institute for Health Research (NIHR), Collaboration for Leadership in Applied Health Research and Care (CLAHRC), North Thames at Bart’s Health NHS Trust and Asthma UK (AUKCAR); Honoraria/consultation fees: AbbVie, Amgen, Astellas, AstraZeneca, Biogen, Erasmus, Idec, Gilead Sciences, GlaxoSmithKline, Janssen, Merck Sharp Dohme, Novartis, Pfizer, Roche, Shire Pharmaceuticals, TEVA. Founder and shareholder of a UCL- Business company (Spoonful of Sugar Ltd) providing consultancy on supporting patients with medicines and treatment-related behaviours to healthcare policy makers, providers and industry. Professor Rob Horne is also supported by the National Institute for Health Research (NIHR, Collaboration for Leadership in Applied Health Research and Care (CLAHRC), North Thames at Bart’s Health NHS Trust and Asthma UK (AUKCAR). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health. Dr Amy Chan: Director of AHYC Consultancy Ltd, providing freelance consultancy to UCL-business company Spoonful of Sugar Ltd; grants from Innovate UK, A+ charitable trust (Auckland District Health Board), Health Research Council, Oakley Mental Health Foundation and Maurice and Phyllis Paykel trust, outside the submitted work. She also received fellowship in 2023 to support research into digital technologies and asthma from Auckland Medical Research Foundation; Contractor in 2022 to advise a Masters student investigating digital technologies and organisations for AcademyeX; co-investigator on a grant to renew funding for the Asthma UK Centre of Applied Research which finishes in 2023; received a grant in 2021 to develop an asthma exacerbation risk prediction model and seed funding in 2023 to look at exhaled breath in asthma from University of Auckland; the recipient of a postdoctoral fellowship from Robert Irwin Pharmacy Foundation from 2019 to 2021; principal investigator on a research grant to look at the acceptability and effect of a digital mental health platform to Maori awarded in 2020 from Chorus Ltd; received research funding for a project in asthma from Life AI Corp; subcontract via UCL in 2021 to conduct qualitative evidence synthesis for TB antigen-based skin testing for World Health Organization; subcontract to conduct pharmacoepidemiology studies in COVID-19 for Hong Kong University. In addition, she is an unpaid board member of Asthma NZ Councillor for Pharmacy Council of New Zealand Member of Research, Policy and Implementation steering committee for ESPACOMP Member of Respiratory Effectiveness Group (REG). The authors report no other conflicts of interest in this work.