Personalized Medicine, Asthma and Allergy, Humanitas Clinical and Research Center IRCCS, Rozzano, MI, Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, MI, Italy.
Società Italiana Farmacia Clinica (SIFAC), Cagliari, Italy.
Respir Med. 2020 Nov-Dec;174:106199. doi: 10.1016/j.rmed.2020.106199. Epub 2020 Oct 21.
Lack of therapeutic adherence is a relevant problem in clinical practice and it can be assessed via validated tools such as the Test of Adherence to Inhalers (TAI). Education on the correct use of inhaler devices has been associated with improvement in adherence. Many studies highlighted the pivotal role of pharmacists in promoting therapeutic adherence in the management of respiratory diseases.
To evaluate the effectiveness on adherence and clinical parameters of an educational intervention administered by clinical pharmacists (CPs) to patients with asthma on long-term inhalation therapy.
A prospective comparative study involving 34 community pharmacies in Italy (23 intervention, 11 control). Enrolled subjects were evaluated for adherence to inhalation therapy by TAI, asthma control by "Asthma Control Test" (ACT), and lung function at baseline and after 2 months. The educational intervention at baseline was based on TAI results and administered by specifically trained pharmacists.
A total of 242 consecutive subjects (167 intervention, 75 control) were enrolled. There was a significant improvement in TAI score, ACT and lung function parameters (p-value<0.001) in the intervention group between baseline and the follow-up visit. Patients with baseline ACT≥20 maintained disease control more frequently in the intervention group compared to the control arm (95% vs 79.5%, p = 0.004). Conclusions through administration of TAI-driven educational interventions addressing both technical and psychological issues, trained CPs can help improve adherence to treatment and asthma control.
治疗依从性差是临床实践中的一个相关问题，可以通过经过验证的工具（如哮喘吸入器依从性测试（TAI））进行评估。教育患者正确使用吸入器与提高依从性有关。许多研究强调了药剂师在促进呼吸系统疾病治疗依从性方面的关键作用。
评估临床药剂师（CPs）对长期吸入治疗的哮喘患者进行教育干预对依从性和临床参数的影响。
这是一项在意大利 34 家社区药房进行的前瞻性比较研究（23 家干预，11 家对照）。通过 TAI 评估患者对吸入治疗的依从性，通过“哮喘控制测试”（ACT）评估哮喘控制情况，并在基线和 2 个月后评估肺功能。基线时的教育干预基于 TAI 结果，并由经过专门培训的药剂师实施。
共纳入 242 例连续患者（167 例干预，75 例对照）。干预组在基线和随访期间 TAI 评分、ACT 和肺功能参数均有显著改善（p 值<0.001）。基线 ACT≥20 的患者在干预组中更频繁地维持疾病控制（95%对 79.5%，p=0.004）。结论：通过实施针对技术和心理问题的 TAI 驱动的教育干预措施，经过培训的 CPs 可以帮助提高治疗依从性和哮喘控制。
