Mixed Age Groups

Pharmacy-Based Asthma Education Program

Article Citation:
Diamond SA, Chapman KR. The impact of a nationally-coordinated pharmacy-based asthma education intervention. Canadian Respiratory Journal 2001;8(4):261-5.

Intervention Setting:
A total of 536 community pharmacies across Canada held a “national asthma clinic day.”

Target Population:
Individuals of all ages whose asthma had been diagnosed by a physician (and parents of children with physician-diagnosed asthma) and who were self-referred for a counseling session with a pharmacist were part of the intervention.

Program Description:
The study objective was to assess the impact of a nationally coordinated, pharmacy-based educational intervention on self-management behavior and markers of asthma control in self-referred patients with asthma. An 8-hour train-the-trainer course prepared 55 pharmacists from across Canada, who in turn trained hundreds of pharmacists over a 3-month period. Trained pharmacists then implemented asthma education in their practices for several months before the nationally advertised asthma clinic day. A counseling room was provided at each pharmacy. On asthma clinic day, patients brought their medications and devices so they could be trained on their use. All the baseline data for the study were acquired by interview during this single day – March 5, 1997. The pharmacist used a questionnaire to guide a 20-minute discussion. A device checklist assessed patient technique. Pharmacists highlighted problems for each patient and suggested individual solutions. Arrangements were made regarding telephone follow-up.

Evaluation Design:
Pharmacists used a structured questionnaire to assess asthma control and self-management in the one-on-one counseling session using standard checklists and questions. A telephone follow-up 30 days later assessed the impact of the teaching. Data collected at the counseling session was compared with data provided at the time of the telephone interview.

Sample Size:
A total of 4,080 people with asthma participated in the study including parents of 255 pre-schoolers, 455 school-aged individuals, 1,324 adults ages 19-64, and 946 adults 65 years of age or older. The ages of 27% of participating patients were not recorded.

Outcome Measures/Results:
Outcome measures included the number of wheezing episodes and other symptoms per week, number of nighttime awakenings per week, and frequency of reliever and preventive medication use. The common problems identified included poor inhaler technique (22%), excessive use of a short acting beta2-agonist (16%), inconsistent use of an inhaled corticosteroid (22%), and manifestations of sub-optional asthma control beyond frequent beta2-agonist use (18%). Of participants, 60% were deemed to need follow-up with their doctors for re-assessment (72% of this group did follow-up). Following the intervention, frequency of reliever medication use and frequency of nighttime awakenings both decreased substantially. The percentage of patients using preventive medications daily rose slightly and the percentage of patients not using preventive medications or using them as needed decreased slightly. These changes were statistically significant.

Availability of Protocol/Materials:
The protocol and materials are not available for widespread distribution.

Case Study: None