Outcome of In-depth Pharmaceutical Care to Quality of Life and Clinical Outcome in Uncontrolled Asthma Patients

Abstract

Introduction: The Asthma Clinic at Banphai Hospital was established in 2004. However, the majority of the patients were found to be suffering from uncontrolled asthma. Therefore, a new approach to service in the Asthma Clinic was found to be necessary. Materials and Method: The study is evaluate the quality of life and clinical outcome before and after in-depth pharmaceutical care of patients with uncontrolled asthma. The study, through a pretest-posttest experimental design was carried on a group patients over the age of 15 years, who for at least the past 6 months had an uncontrolled level of asthma as per the 2009 guidelines of the Global Initiative for Asthma (GINA). Patients participating in the study were given an in-depth pharmaceutical care depending on a patient’s individual needs. Clinical outcome were measured every 2 months and patients with continued uncontrolled asthma were visited at home by a multidisciplinary team within 7 days for further care for the next six month period. Quality of Life was measured using the  MiniAsthma Quality of Life Questionnaire (MiniAQLQ), Thai version.  Results: A total of 46 patients were recruited, mostly female (58.7%), majority non-smoking (71.7%), and mean age 59.4 years. After in-depth pharmaceutical care, the overall average quality of life was increased from 4.00 ± 0.95 to 5.04 ± 0.88 points  (p<0.001) and increased significantly in every dimension; the number of uncontrolled asthmatic patients decreased from 46 (100%) to 19 patients (41.3%) (p<0.001), the average lung function as measured by  PEFR increased from 58.5 ±23.3% to 66.2±24.3% (p<0.001), and the of patients who visited the emergency department and/or had hospital admission was decreased (p=0.439 and  p=0.317 respectively). Conclusion: The in-depth pharmaceutical care to uncontrolled asthmatic patients can improve the quality of life and clinical outcome.