Medicine Use in Upper Respiratory Airways and Asthma

A special issue of Pharmacy (ISSN 2226-4787).

Deadline for manuscript submissions: closed (31 May 2020) | Viewed by 19386

Special Issue Editors


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Guest Editor
Sydney Pharmacy School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia
Interests: allergic rhinitis; primary health care; asthma

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Guest Editor
Woolcock Institute of Medical Research, University of Sydney, Sydney, Australia
Interests: quality use of respiratory medicines; inhaler technique; primary care; allergic rhinitis and asthma

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Guest Editor
Woolcock Institute of Medical Research, University of Sydney, Sydney, Australia
Interests: quality use of respiratory medicines; inhaler technique; primary care; allergic rhinitis and asthma

Special Issue Information

Dear Colleagues,

Chronic, allergic, airway diseases, specifically asthma and rhinitis, are on the rise worldwide, and represent an enormous health and economic burden to individuals, healthcare systems, and society. When it comes to the management of these conditions, which often coexist, the inappropriate use of medications is a major issue and remains a persistent barrier to achieving optimal patient outcomes. This has been highlighted by the recent Lancet Asthma Commission, calling for effective methods of identifying and addressing non-adherence to inhaled preventative asthma medication, and Allergic Rhinitis and its Impact on Asthma (ARIA) in Pharmacy, identifying the need for delivery of strategies and interventions that address suboptimal rhinitis and asthma control arising from suboptimal treatment.

Pharmacists are trusted healthcare professionals who play an increasingly important role in primary care. They are ideally placed to deliver timely interventions that promote and facilitate the quality use of medicines and support patients in self-management, in view of their therapeutic expertise, accessibility, regular contact with patients and contact with patients who do not visit other healthcare providers regularly. Previous research has shown that pharmacists can improve clinical outcomes in asthma and allergic rhinitis patients with interventions targeting inhaler technique and goal setting. New approaches such as integrated care pathways that focus on the quality and coordination of care and change management, as well as the use of technology, are now being explored.

We invite you to share your approaches to promoting and facilitating the quality use of respiratory medicines either in primary or tertiary care settings. We hope this Special Issue will encourage healthcare researchers to share their strategies and healthcare models that will help achieve and sustain optimal patient outcomes for individuals living with these chronic respiratory conditions.

Prof. Sinthia Bosnic-Anticevich
Dr. Vicky Kritikos
Ms. Biljana Cvetkovski
Guest Editors

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Keywords

  • Asthma
  • Allergic rhinitis
  • Primary care
  • Pharmacy
  • Quality use of respiratory medicines
  • Inhaler technique
  • Adherence
  • Short-acting beta agonists

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Published Papers (4 papers)

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Research

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19 pages, 631 KiB  
Article
Medication Adherence in a Community Population with Uncontrolled Asthma
by Sarah Serhal, Bandana Saini, Sinthia Bosnic-Anticevich, Ines Krass, Frances Wilson and Carol Armour
Pharmacy 2020, 8(4), 183; https://doi.org/10.3390/pharmacy8040183 - 7 Oct 2020
Cited by 6 | Viewed by 3344
Abstract
It is well documented that the use of medications in asthma and allergic rhinitis is often suboptimal, and consequently, patients remain symptomatic. This study aimed to determine the extent and type of medication-related issues contributing to poor asthma control by profiling medication management [...] Read more.
It is well documented that the use of medications in asthma and allergic rhinitis is often suboptimal, and consequently, patients remain symptomatic. This study aimed to determine the extent and type of medication-related issues contributing to poor asthma control by profiling medication management in those most at risk—a population with clinically uncontrolled asthma. Participants (n = 363) were recruited from Australian community pharmacies, and a dispensed medication history report for the previous 12 months was collected to examine medication adherence and factors affecting adherence. Information was also collected regarding participant asthma control and asthma/allergic rhinitis (if applicable) management. The participants’ mean asthma control score was 2.49 (± 0.89 SD, IQR = 1.20) (score ≥ 1.5 indicative of poorly controlled asthma), and 72% were either non-adherent or yet to initiate preventer therapy. Almost half had been prescribed high doses of inhaled corticosteroid and 24% reported use of oral corticosteroids. Only 22% of participants with concomitant allergic rhinitis were using first line treatment. A logistic regression model highlighted that participant health care concession status and hospital admissions were associated with better adherence. Suboptimal medication management is evident in this at-risk population. Full article
(This article belongs to the Special Issue Medicine Use in Upper Respiratory Airways and Asthma)
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12 pages, 229 KiB  
Article
Qualitative Exploration of Pharmacists’ Feedback Following the Implementation of an “Allergic Rhinitis Clinical Management Pathway (AR-CMaP)” in Australian Community Pharmacies
by Biljana Cvetkovski, Lynn Cheong, Rachel Tan, Vicky Kritikos, Janet Rimmer, Jean Bousquet, Kwok Yan and Sinthia Bosnic-Anticevich
Pharmacy 2020, 8(2), 90; https://doi.org/10.3390/pharmacy8020090 - 26 May 2020
Cited by 3 | Viewed by 2752
Abstract
Allergic Rhinitis (AR) is both a common and high burden disease, with the majority of AR sufferers purchasing suboptimal/inappropriate AR medication from community pharmacies. Unfortunately, it is still a challenge to translate the AR management guidelines that are available at both a global [...] Read more.
Allergic Rhinitis (AR) is both a common and high burden disease, with the majority of AR sufferers purchasing suboptimal/inappropriate AR medication from community pharmacies. Unfortunately, it is still a challenge to translate the AR management guidelines that are available at both a global and national level into practice. This study aimed to explore the experiences and perceptions of community pharmacists with regards to the implementation of AR management guidelines in real-life everyday practice. This exploration took the form of a qualitative research study in which pharmacists were interviewed following the implementation of a guideline-driven AR management pathway in their pharmacies. Fifteen pharmacists from six pharmacies agreed to participate in a telephone interview. Five themes were identified that encompassed the sentiment of the pharmacists during the interviews: (1) impact of training on pharmacists’ approach to patients and AR management recommendations; (2) patient engagement and the importance of appropriate tools; (3) patient barriers to change in practice; (4) physical, logistical, and inter-professional barriers to change within the pharmacy environment; and (5) recommendations for improvement. The results of this study indicate that, following the implementation of an AR management pathway, pharmacists believe that their interactions with patients around their AR were enhanced through the use of appropriate tools and education. However, if optimal AR management is to be delivered within the community pharmacy setting, the undertaking needs to be collaborative with both pharmacy assistants and general practitioners. Full article
(This article belongs to the Special Issue Medicine Use in Upper Respiratory Airways and Asthma)
14 pages, 1352 KiB  
Article
Managing Allergic Rhinitis in the Pharmacy: An ARIA Guide for Implementation in Practice
by Olga Lourenço, Sinthia Bosnic-Anticevich, Elísio Costa, João A. Fonseca, Enrica Menditto, Biljana Cvetkovski, Vicky Kritikos, Rachel Tan, Anna Bedbrook, Sophie Scheire, Claus Bachert, Sławomir Białek, Vitalis Briedis, Koen Boussery, G. Walter Canonica, Tari Haahtela, Piotr Kuna, Ettore Novellino, Bolesław Samoliński, Holger J. Schünemann, Dana Wallace and Jean Bousquetadd Show full author list remove Hide full author list
Pharmacy 2020, 8(2), 85; https://doi.org/10.3390/pharmacy8020085 - 16 May 2020
Cited by 17 | Viewed by 9535
Abstract
The paradigm of how we manage allergic rhinitis is shifting with a growing understanding that it is a complex process, requiring a coordinated effort from healthcare providers and patients. Pharmacists are key members of these integrated care pathways resolving medication-related problems, optimizing regimens, [...] Read more.
The paradigm of how we manage allergic rhinitis is shifting with a growing understanding that it is a complex process, requiring a coordinated effort from healthcare providers and patients. Pharmacists are key members of these integrated care pathways resolving medication-related problems, optimizing regimens, improving adherence and recommending therapies while establishing liaisons between patients and physicians. Community pharmacists are the most accessible healthcare professionals to the public and allergic rhinitis is one of the most common diseases managed by pharmacists. Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines developed over the past 20 years have improved the care of allergic rhinitis patients through an evidence-based, integrated care approach. In this paper, we propose an integrated approach to allergic rhinitis management in community pharmacy following the 2019 ARIA in the pharmacy guidelines. Full article
(This article belongs to the Special Issue Medicine Use in Upper Respiratory Airways and Asthma)
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Review

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9 pages, 606 KiB  
Review
Interventions Delivered in the Community Pharmacy to Manage Allergic Rhinitis- A Systematic Review of the Literature
by Jéssica José, Biljana Cvetkovski, Vicky Kritikos, Rachel Tan, Sinthia Bosnic-Anticevich and Olga Lourenço
Pharmacy 2020, 8(2), 80; https://doi.org/10.3390/pharmacy8020080 - 6 May 2020
Cited by 3 | Viewed by 3075
Abstract
Pharmacists have a valuable role in the management of allergic rhinitis (AR) at the community pharmacy level. This role has been reported extensively in numerous papers. However, a systematic review of the available literature and a comprehensive analysis of the outcomes has not [...] Read more.
Pharmacists have a valuable role in the management of allergic rhinitis (AR) at the community pharmacy level. This role has been reported extensively in numerous papers. However, a systematic review of the available literature and a comprehensive analysis of the outcomes has not been published. This systematic review aimed to evaluate the impact of interventions developed by pharmacists on clinical AR outcomes. A thorough search was performed in three electronic databases, including studies published between January 2000 and June 2019. After the selection process, only three articles met the inclusion criteria and were further analysed. Despite the scarcity of the available studies, in all of them was clear that the pharmacist plays a pivotal role in the management of AR, significantly improving the patients’ quality of life and symptom control. This systematic review also stresses the utmost importance to investigate and report practices and interventions developed by pharmacists using measurable outcomes. Full article
(This article belongs to the Special Issue Medicine Use in Upper Respiratory Airways and Asthma)
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