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改善哮喘管理:患者-药剂师合作项目以提高治疗依从性。

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

作者信息

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

机构信息

Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, AB T6G 2E1, Canada.

College of Pharmacy, The University of Texas at Austin, Austin, TX 78712, USA.

出版信息

Pharmacy (Basel). 2022 Feb 17;10(1):34. doi: 10.3390/pharmacy10010034.

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.

摘要

社区药剂师的干预措施有助于提高哮喘患者的依从性。本研究的目的是评估使用开发的哮喘专用工具进行以患者为中心的咨询的可行性,以识别依从性障碍,并确定其对依从性障碍评分和哮喘控制的初步影响。邀请成年持续性哮喘患者参加一项为期3个月的干预前后研究,该研究包括社区药剂师提供的以患者为中心的咨询。进行双变量分析以确定从干预前到干预后结果是否有变化。在36名招募的患者中,17名完成了干预前和干预后的调查。基线时,患者的平均ACT评分为15.1±3.5,94%的患者哮喘未得到控制,平均报告的障碍为4.2±2.5个。以下障碍最为常见:没有哮喘行动计划(52.9%)、吸入器使用频率高于或低于规定(47.1%)以及健忘(41.2%)。ACT评分增加了2.7±5.4,无统计学意义;然而,可能具有临床意义。两项障碍评分因干预而有所改善。关于药剂师识别和解决患者特定依从性障碍的可行性的初步证据表明,它有可能解决障碍并改善哮喘结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f508/8878305/17a0a87c59e8/pharmacy-10-00034-g001.jpg

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