A Longitudinal Study of Pharmaceutical Care in Asthmatic Patients, Easy Asthma Clinic

Abstract

Introduction: Change in Easy Asthma Clinic (EAC) management at Sunpasitthiprasong Hospital by including pharmacists on multidisciplinary team to provide pharmaceutical care may affect the outcomes of medical care for patients with asthma. The purposes of this study were to evaluate the outcomes of pharmaceutical care provided for asthmatic patients and identify the time lag between pharmaceutical care provision and its outcomes. Methods: This longitudinal observational study included patients with asthma who met the inclusion criteria and received pharmaceutical care services at EAC between October 2011 to September 2012. Demographic information, prescribed medications, and level of asthma control (uncontrolled, partially controlled, controlled) were retrieved from medical records and electronic medical database. Demographic and prescribed medications data were analyzed by descriptive statistics. Trend of level of asthma control was analyzed by chi-squared for trend statistics. Time lag between pharmaceutical care provision and levels of asthma control was analyzed by multilevel logistic regression. Results: Among 86 patients with asthma, the average age was 52.87 ± 15.23 years old and 84.88% were female. The proportion of patients with level of asthma controlled increased significantly (X² = 9.69. p<0.005), from 12.79% to 17.44% in 6 months and 33.33% in 12 months after continuously providing pharmaceutical care. The proportion of patients with daytime symptoms £2 episodes/week or no nighttime symptoms increased significantly (X² = 11.675, p<0.001 และ x²= 15.173, p<0.001 respectively) whereas the proportion of patients who came to emergency visit or were readmitted decreased significantly (X²= 6.756, p<0.01 และ x²= 6.374, p<0.005 respectively). Compared to the baseline, the levels of asthma control at 3 months and 6 months were not significantly different. At 12 months, however, asthmatic patients were 8.19 times more likely to have better level of asthma control when compared with baseline (OR = 8.19, 95% Cl = 2.67-25.06, p<0.001). Conclusion: Patients had better level of asthma control after receiving pharmaceutical care. Emergency room visits and readmission cases were also decreased. The effect of pharmaceutical care was significantly observed at 12 months. Therefore, pharmacists should participate in EAC by routinely providing pharmaceutical care for asthmatic patients.