Barbanel D, Eldridge S, Griffiths C
Institute of Community Health Sciences, Barts and the London, Queen Mary's School of Medicine and Dentistry, London E1 4NS, UK.
Thorax. 2003 Oct;58(10):851-4. doi: 10.1136/thorax.58.10.851.
No randomised studies have addressed whether self-management for asthma can be successfully delivered by community pharmacists. Most randomised trials of asthma self-management have recruited participants from secondary care; there is uncertainty regarding its effectiveness in primary care. A randomised controlled study was undertaken to determine whether a community pharmacist could improve asthma control using self-management advice for individuals recruited during attendance at a community pharmacy.
Twenty four adults attending a community pharmacy in Tower Hamlets, east London for routine asthma medication were randomised into two groups: the intervention group received self-management advice from the pharmacist with weekly telephone follow up for 3 months and the control group received no input from the pharmacist. Participants self-completed the North of England asthma symptom scale at baseline and 3 months later.
The groups were well matched at baseline for demographic characteristics and mean (SD) symptom scores (26.3 (4.8) and 27.8 (3.7) in the intervention and control groups, respectively). Symptom scores improved in the intervention group and marginally worsened in the control group to 20.3 (4.2) and 28.1 (3.5), respectively (p<0.001; difference adjusted for baseline scores=7.0 (95% CI 4.4 to 9.5).
A self-management programme delivered by a community pharmacist can improve asthma control in individuals recruited at a community pharmacy. Further studies should attempt to confirm these findings using larger samples and a wider range of outcome measures.
尚无随机研究探讨社区药剂师能否成功提供哮喘自我管理服务。大多数哮喘自我管理的随机试验招募的参与者来自二级医疗保健机构；其在初级医疗保健中的有效性尚不确定。开展了一项随机对照研究，以确定社区药剂师能否通过为在社区药房就诊的个体提供自我管理建议来改善哮喘控制情况。
24名在伦敦东部陶尔哈姆莱茨区一家社区药房购买常规哮喘药物的成年人被随机分为两组：干预组接受药剂师的自我管理建议，并在3个月内每周接受电话随访，对照组未接受药剂师的任何指导。参与者在基线时和3个月后自行填写英格兰北部哮喘症状量表。
两组在基线时的人口统计学特征和平均（标准差）症状评分匹配良好（干预组和对照组分别为26.3（4.8）和27.8（3.7））。干预组的症状评分有所改善，而对照组的症状评分略有恶化，分别为20.3（4.2）和28.1（3.5）（p<0.001；根据基线评分调整后的差异=7.0（95%可信区间4.4至9.5））。
社区药剂师提供的自我管理方案可改善在社区药房招募的个体的哮喘控制情况。进一步的研究应尝试使用更大的样本和更广泛的结局指标来证实这些发现。
