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Improving Asthma Management: Patient–Pharmacist Partnership Program in Enhancing Therapy Adherence

by Tatiana Makhinova, Jamie C. Barner, Carolyn M. Brown, Kristin M. Richards, Karen L. Rascati and Arpita Nag

Pharmacy 2022, 10(1), 34; https://doi.org/10.3390/pharmacy10010034 - 17 Feb 2022

Cited by 12 | Viewed by 6973

Abstract

Community pharmacist interventions can assist in improving adherence in patients with asthma. The objective of the study was to assess the feasibility of patient-centered counseling using the developed asthma-specific tools to identify barriers to adherence and identify their preliminary effect on adherence barrier score and asthma control. Adult patients with persistent asthma were invited to participate in a 3-month pre–post intervention study involving community pharmacist-provided patient-centered counseling. Bivariate analyses were conducted to determine whether there were changes in outcomes from the pre to post period. Of 36 recruited patients, 17 completed both pre and post surveys. At baseline, patients had a mean ACT score of 15.1 ± 3.5, with 94% having uncontrolled asthma, and an average of 4.2 ± 2.5 reported barriers. The following barriers were most common: not having an Asthma Action Plan (52.9%), use of inhaler more or less often than prescribed (47.1%) and forgetfulness (41.2%). The ACT score increased by 2.7 ± 5.4, which was not statistically significant; however, it might be clinically significant. Two barrier scores improved as a result of the intervention. Preliminary evidence on the feasibility of identifying and addressing patient-specific barriers to adherence delivered by pharmacists showed that it has the potential to resolve barriers and improve asthma outcomes. Full article

(This article belongs to the Special Issue Medicine Use in Chronic Disease)

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20 pages, 664 KiB

Open AccessArticle

Experience of Patients with COPD of Pharmacists’ Provided Care: A Qualitative Study

by Omowumi Idowu, Tatiana Makhinova, Maira Quintanilha, Nese Yuksel, Theresa J. Schindel and Ross T. Tsuyuki

Pharmacy 2021, 9(3), 119; https://doi.org/10.3390/pharmacy9030119 - 29 Jun 2021

Cited by 7 | Viewed by 5873

Abstract

Chronic obstructive pulmonary disease (COPD) is associated with high global morbidity and mortality. Pharmacists are uniquely positioned to provide services which may reduce the burden of this disease on the health system, patients, and their families. The study aimed to understand the perceptions and experiences of patients living with COPD with pharmacists’ provided care in COPD diagnosis and management. The study was guided by qualitative description methodology and reported using the consolidated criteria for reporting qualitative research (COREQ) checklist. We conducted semi-structured interviews with 12 participants who were recruited from community pharmacies, seniors’ centres, a general practice clinic, and a pulmonary rehabilitation centre. Using qualitative content analysis, we identified categories that revealed great variation in participants’ experience of pharmacy care based on the depth of patient–pharmacist engagement. Participants who regarded their pharmacists as an essential member of their healthcare team and those who did not, had contrasting experiences with education, communication, and ability to form connections with their pharmacists. For patients with COPD, it is important that the pharmacist is proactive in engaging patients through effective communication, education/provision of relevant information, identification of patient needs, and consistent provision of care with empathy. Full article

(This article belongs to the Special Issue Pharmacists as Providers of Care)

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12 pages, 261 KiB

Open AccessArticle

Checking Inhaler Technique in the Community Pharmacy: Predictors of Critical Errors

by Tatiana Makhinova, Brandie L. Walker, Marlene Gukert, LeAnna Kalvi and Lisa M. Guirguis

Pharmacy 2020, 8(1), 6; https://doi.org/10.3390/pharmacy8010006 - 7 Jan 2020

Cited by 9 | Viewed by 4697

Abstract

Inhaled medications are critical in the pharmaceutical management of respiratory conditions, however, the majority of patients demonstrate at least one critical error when using an inhaler. Since community pharmacists can be instrumental in addressing this care gap, we aimed to determine the rate and type of critical inhaler errors in community pharmacy settings, elucidate the factors contributing to inhaler technique errors, and identify instances when community pharmacists check proper inhaler use. Fourth year pharmacy students on community practice placement (n = 53) identified 200 patients where at least one error was observed in 78% of participants when demonstrating inhaler technique. Prevalent errors of the users were associated with metered dose inhaler (MDI) (55.6%), Ellipta^® (88.3%), and Discus^® (86.7%) devices. Overall, the mean number of errors was 1.09. Possession of more than one inhaler, use of rescue inhaler, and poor control of asthma were found to be significant predictors of having at least one critical error. In all participating pharmacies, inhaler technique is mainly checked on patient request (93.0%) and for all new inhalers (79.0%). Full article

(This article belongs to the Special Issue Community Pharmacists and Optimization of Patient Medication Use)

14 pages, 432 KiB

Open AccessArticle

“Being in Control of My Asthma Myself” Patient Experience of Asthma Management: A Qualitative Interpretive Description

by Damilola T. Olufemi-Yusuf, Sophie Beaudoin Gabriel, Tatiana Makhinova and Lisa M. Guirguis

Pharmacy 2018, 6(4), 121; https://doi.org/10.3390/pharmacy6040121 - 15 Nov 2018

Cited by 3 | Viewed by 5809

Abstract

Asthma control can be achieved with effective and safe medication use; however, many patients are not controlled. Patients’ perceptions of asthma, asthma treatment, and pharmacist roles can impact patient outcomes. The purpose of this study was to explore patients’ experiences and patient–pharmacist relationships in asthma care. Qualitative Interpretive Description method guided the study. Semi-structured individual interviews were conducted with 11 patients recruited from personal contacts, pharmacies, and asthma clinics. Categories and themes were identified using inductive constant comparison. Themes indicated patients had a personalized common sense approach to asthma management, “go-to” health care provider, and prioritized patient–pharmacist relationships. Patients described their illness experiences and asthma control based on personal markers similar to the common sense model of self-regulation. Patients chose a family physician, asthma specialist, respiratory therapist, or pharmacist as an expert resource for asthma management. Patient perceived pharmacists’ roles as information provider, adviser, or care provider. Pharmacists who develop a collaborative relationship with their asthma patients are better positioned to provide tailored education and self-management support. Inviting patients to share their perspective could increase patient engagement and uptake of personalised asthma action plans to achieve asthma control. Full article

(This article belongs to the Special Issue Communication in Pharmacy Practice)

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