Pharmacist’s intervention on clinical asthma outcomes: Systematic review

Abstract

Abstract

Background: Improving asthma outcomes has become a global concern for healthcare systems. The purpose of this review was to determine if pharmacist intervention could improve clinical outcomes in adult asthmatic patients. Ineffective disease management is often the cause of the negative economic, clinical, and humanistic implications associated with asthma. Method: PubMed and ScienceDirect were used to identify the nine studies included in this qualitative synthesis. The searches included studies in the English language and published during the last ten years (2010- 2020). Studies were reviewed and selected based on the inclusion and exclusion criteria. To assess the quality of the included studies, the review used the Critical Appraisal Skills Programme (CASP) tool. The delivery mode, frequency, and content of the interventions were considered to evaluate the effect of the studies on asthma control, symptom scoring and reporting, lung function, inhaler technique, and medication adherence.

Results: 701 studies from the electronic search were identified. After screening only nine studies met the eligibility criteria. Of the nine studies identified, four were of a randomized control trial design, three were cluster randomized control trials, one was a cluster randomized trial, and the final was a quasi-experimental study with no control group design. Most of the interventions in the nine studies showed an improved on the clinical asthma outcomes. Overall, the mean age of the included studies was 48.5 ± 7.1, 40.7% ± 10.0 of participants were male, and the median sample size was 157 participants.

Conclusion: This reviewed found that pharmacist intervention does improve clinical asthma outcomes overall; however, further research is needed on the topic. Interventions such as inhaler technique, asthma control and self-management techniques, medication and adherence, symptoms and trigger factors, and the provision of asthma action plans are improve clinical outcomes in symptom scores, inhaler technique, and medication adherence, but not lung function. The mode of delivery is important; telepharmacy methods were able to improve medication adherence but not asthma control. However, it was not found necessary to provide written materials. Due to the participant populations in each of the included studies, it is likely that newly diagnosed patients would benefit the most from interventions of this type; however, this would have to be explored in future studies to confirm the hypothesis. Additionally, future trials should explore the long-term effects of the intervention, as well as the optimal frequency, duration, and protocol in order to achieve the most cost and time-effective methods to balance the cost vs benefit ratio