Journal ArticleDOI
Improving Drug Therapy for Patients with Asthma-Part 2: Use of Antiasthma Medications
Hanne Herborg,Birthe Soendergaard,Tove Jorgenaen,Lotte Fonneabaek,Charlea D Hepler,Helle Holst,Bente Froekjaer +6 more
TLDR
Changes in medication use among TOM patients were toward improved asthma treatment, and the results show that community pharmacists, physicians, and patients, working together, can improve prescribing, solve drug therapy problems, and improve outcomes for patients with moderate-to-severe asthma.Abstract:
Objectives To describe the use of antiasthma drugs among the study patients and to evaluate whether therapeutic outcomes monitoring (TOM) is associated with improved quality of drug therapy. Design Prospective, controlled, multicenter study. Consumption of antiasthma medications was measured as the number of defined daily doses (DDDs) purchased. Data were collected from the pharmacies' computer systems for a period beginning 6 months before the start of the study (period 1) and during its first and second half-years (periods 2 and 3). Treatment changes for TOM patients were classified on the basis of drug regimens at periods 1 and 3. Setting Community pharmacies in Denmark (16 intervention, 15 control). Patients Five hundred patients with asthma aged 16 to 60 years who were being treated in primary health care; this study used data from 350 patients from this sample. Intervention TOM. Main outcome measures Changes in the use of individual drugs and changes in therapeutic patterns--distribution of purchased drugs; proportion of corticosteroid users; frequency of drug regimens used; treatment changes for TOM patients. Results TOM patients' consumption of beta2-agonists decreased by 12% overall from period 1 through period 3, while control patients' consumption of these medications decreased by only 1%. TOM patients' use of inhaled corticosteroids increased by more than 50% compared with 9% among controls. In both groups, about one-half of all purchased DDDs were for inhaled beta2-agonists. The proportion of inhaled corticosteroids increased from 27% to 42% of total DDDs for the TOM group and remained constant for controls. Of patients using beta2-agonists, 68% also used inhaled steroids initially in both the TOM and control groups. The proportion of inhaled steroid users in the TOM group increased to 84%, and to 70% among controls. The most common regimen was inhaled short-acting beta2-agonists and corticosteroids in combination, and the second most common regimen was monotherapy with short-acting beta2-agonists. With time, the regimens changed more toward consensus guidelines among TOM patients. Changes in drug therapy totaled 451, averaging 2.4 changes per TOM patient. The largest number of changes (49%) involved inhaled corticosteroids. Conclusion Changes in medication use among TOM patients were toward improved asthma treatment. Our results show that community pharmacists, physicians, and patients, working together, can improve prescribing, solve drug therapy problems, and improve outcomes for patients with moderate-to-severe asthma.read more
Citations
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Journal ArticleDOI
A systematic review and meta-analysis of pharmacist-led fee-for-services medication review
TL;DR: Interventions that include a clinical review had a significant impact on patient outcomes by attainment of target clinical biomarkers and reduced hospitalization.
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Pharmaceutical care, European developments in concepts, implementation, teaching, and research: a review.
TL;DR: The current status of pharmaceutical care research and implementation, and if and how it can be part of the practice of pharmacy is clarified.
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Research: Improving Drug Therapy for Patients with Asthma-Part 1: Patient Outcomes
Hanne Herborg,Birthe Soendergaard,Bente Froekjaer,Lotte Fonnesbaek,Tove Jorgensen,Charles D. Hepler,Timothy-John Grainger-Rousseau,Bjarne Kjaer Ersboell +7 more
TL;DR: In this article, the authors evaluated the effects of a therapeutic outcomes monitoring (TOM) program on selected process and outcome measures, including asthma symptom status, days of sickness, health-related and asthma-specific quality of life, use of health care services and resources, and satisfaction with health care and pharmacy.
Journal ArticleDOI
Development, Implementation, and Evaluation of a Community Pharmacy–Based Asthma Care Model
TL;DR: Based on the results of this study, it appears that a specialized asthma care model offers community pharmacists an opportunity to contribute toward improving asthma management in the Australian community.
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Interventions to Modify Health Care Provider Adherence to Asthma Guidelines: A Systematic Review
Sande O. Okelo,Arlene M. Butz,Ritu Sharma,Gregory B. Diette,Samantha I. Pitts,Tracy M. King,Shauna Linn,Manisha Reuben,Yohalakshmi Chelladurai,Karen A. Robinson +9 more
TL;DR: In this article, the authors assess the effect of interventions to improve health care providers adherence to asthma guidelines on health care process and clinical outcomes and find that decision support tools, feedback and audit, and clinical pharmacy support were most likely to improve provider adherence to guidelines.
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