Brown Wendy, Scott David, Friesner Daniel, Schmitz Tara
a Algorithme Pharma USA , Fargo , ND , USA.
b College of Pharmacy, Nursing, and Allied Sciences, North Dakota State University , Fargo , ND , USA.
J Asthma. 2017 Nov;54(9):961-967. doi: 10.1080/02770903.2017.1281292. Epub 2017 Jan 17.
To demonstrate that real-time, telepharmacy-based asthma educational services are feasible and to support the efforts of local primary care prescribers to improve patient outcomes.
The lead investigator (a pharmacist, physician assistant, and certified asthma educator) identified an independent community pharmacy with telehealth capabilities in a rural area with a high prevalence of asthma. Working with the pharmacy, an asthma education program was developed based on the National Asthma Education and Prevention Program guidelines. It consisted of three monthly education visits, with subsequent visits every three months for one year. The Asthma Control Test (ACT) was administered at baseline and at each visit to assess a patient's perception of asthma control.
Eighteen of 20 patients (90%) with reversible airway disease completed all six visits in this year-long study. For the 18 patients, the mean ACT scores of 18 at baseline (initiation of intervention) did not meet the threshold for "well-controlled" asthma. By the third educational visit (3 months), 16 patients met ACT criteria for well-controlled asthma (mean score = 20), and they maintained control for the remaining 9-month follow-up period (ACT ≥ 21). Local prescribers authorized medication changes recommended by the asthma educator 20 times and also requested six direct consults with the asthma educator over the study period.
Using the local community pharmacy as a vehicle to deliver asthma education services by telepharmacy was utilized by local prescribers. The findings show this is an effective means to engage patients to gain and maintain asthma control.
证明基于远程药房的实时哮喘教育服务是可行的，并支持当地初级保健开方者改善患者治疗效果的努力。
首席研究员（一名药剂师、医师助理和认证哮喘教育工作者）在哮喘患病率高的农村地区确定了一家具备远程医疗能力的独立社区药房。与该药房合作，根据国家哮喘教育和预防计划指南制定了一项哮喘教育计划。该计划包括每月三次教育访视，随后在一年内每三个月进行一次访视。在基线和每次访视时进行哮喘控制测试（ACT），以评估患者对哮喘控制的认知。
在这项为期一年的研究中，20例可逆性气道疾病患者中有18例（90%）完成了全部六次访视。对于这18例患者，基线时（干预开始时）的平均ACT评分为18分，未达到“控制良好”哮喘的阈值。到第三次教育访视时（3个月），16例患者达到了ACT控制良好哮喘的标准（平均评分=20），并且在剩余的9个月随访期内保持了控制（ACT≥21）。在研究期间，当地开方者20次批准了哮喘教育工作者建议的药物变更，还要求与哮喘教育工作者进行6次直接咨询。
当地开方者利用当地社区药房作为通过远程药房提供哮喘教育服务的载体。研究结果表明，这是促使患者获得并维持哮喘控制的有效手段。
