School of Medicine and Pharmacology, Centre for Optimisation of Medicines, Pharmacy, The University of Western Australia, Crawley, WA, Australia.
Community Pharmacy, School of Pharmaceutical Sciences, University of Geneva, University of Lausanne, Geneva, Switzerland.
NPJ Prim Care Respir Med. 2016 Nov 24;26:16082. doi: 10.1038/npjpcrm.2016.82.
There are many indications in Australia and globally that asthma management is suboptimal. Ideally, patients need to proactively self-manage the condition with the support of health professionals. Community pharmacists are a highly accessible resource for patients but currently provide inconsistent services. General practitioners also face many barriers to the provision of chronic disease management for asthma patients. The aim of this research was to characterise patients with asthma who present to community pharmacy. The objective was to identify opportunities to develop the role of pharmacists in the context of the primary healthcare setting and in view of the needs of the patients they routinely encounter. The results of a comprehensive survey of 248 patients recruited from community pharmacies indicated there was discordance between patient perceptions of asthma control and actual asthma control. Almost half the patients surveyed had poorly controlled asthma, whereas almost three quarters perceived their asthma to be well or completely controlled. Fewer than 20% of patients were utilising written asthma action plans, and issues around quality use of medicines were identified. The significance of the incongruent perceptions regarding asthma control is that patients are unlikely to proactively seek intervention and support from healthcare professionals. Community pharmacists provide a significant opportunity to address these issues by direct intervention. There is scope to investigate pharmacists preparing written asthma action plans for patients, using software to monitor medication adherence and prescribe on-going medication. To maximise the potential of pharmacists, barriers to practice need to be identified and addressed.
在澳大利亚和全球范围内,有许多迹象表明哮喘管理并不理想。理想情况下,患者需要在卫生专业人员的支持下积极主动地自我管理病情。社区药剂师是患者高度可及的资源,但目前提供的服务不一致。全科医生在为哮喘患者提供慢性病管理方面也面临许多障碍。这项研究的目的是描述到社区药房就诊的哮喘患者。其目的是确定在初级保健环境中以及考虑到他们经常遇到的患者的需求,发展药剂师角色的机会。从社区药房招募的 248 名患者进行的一项全面调查的结果表明,患者对哮喘控制的看法与实际哮喘控制之间存在差异。接受调查的患者中几乎有一半哮喘控制不佳,而近四分之三的患者认为他们的哮喘控制良好或完全控制。不到 20%的患者正在使用书面哮喘行动计划,并且发现了一些药物使用质量问题。对哮喘控制的不一致看法的重要意义在于,患者不太可能主动寻求医疗保健专业人员的干预和支持。社区药剂师通过直接干预提供了解决这些问题的重要机会。可以探索药剂师为患者制定书面哮喘行动计划,使用软件来监测药物依从性并开出处方药物。为了最大限度地发挥药剂师的潜力,需要确定并解决实践中的障碍。