Kroenert Ann-Christin, Freyberg Lucas, Sehmisch Claudia, Michael Sebastian, Bertsche Thilo
Department of Clinical Pharmacy, Institute of Pharmacy, Medical Faculty, Leipzig University, Leipzig, Germany.
Drug Safety Center, Leipzig University, Leipzig, Germany.
J Eval Clin Pract. 2025 Sep;31(6):e70271. doi: 10.1111/jep.70271.
Outcome studies have shown the benefits of inhalation consultations. Therefore, the service of inhalation consultations from pharmacists has been implemented in guidelines. Recently, this service became reimbursable for German community pharmacies.
We aimed to investigate how this service is performed under routine conditions to actually achieve the proven benefits.
We evaluated the reimbursed inhalation service under routine conditions in community pharmacies in Saxony, Germany. An external trained monitor observed routine services and documented predefined handling errors in patients' inhalation demonstrations. Besides, the monitor checked which contents of predefined checklists were addressed. After the consultations, patients and pharmaceutical staff were asked about the pervious service via a questionnaire.
We analysed 48 reimbursed inhalation services in 13 different community pharmacies. Most consultations were on metered dose inhalers and dry powder inhalers, with 42% (20/48) each. We observed a median of n = 2 handling errors per patient (Q25: 1; Q75: 3). On average, 77% of those two errors were addressed by the pharmaceutical staff during the following consultation (95% confidence interval [69%; 86%]; minimum: 0%; maximum: 100%). Overall, patients' contentment with the service was very high (overall median: 5), while pharmaceutical staff's contentment was high (overall median: 4). There was no correlation between duration and unaddressed errors (r = 0.16; p = 0.35) or patients' contentment (r = 0.19; p = 0.26).
Handling errors in patients' inhalation technique were common but mostly recognized and addressed by the pharmaceutical staff during the reimbursed inhalation service. Patients' contentment with the service was high to very high, and they were usually more content with the service than the pharmaceutical staff.
结果研究表明吸入咨询服务具有益处。因此，药剂师提供的吸入咨询服务已被纳入指南。最近，这项服务在德国社区药房可获得报销。
我们旨在调查在常规条件下如何提供这项服务，以切实实现已证实的益处。
我们评估了德国萨克森州社区药房常规条件下可报销的吸入服务。一名经过外部培训的监测人员观察常规服务，并记录患者吸入示范中预先定义的操作错误。此外，监测人员检查预先定义清单中的哪些内容得到了处理。咨询结束后，通过问卷调查询问患者和药房工作人员对先前服务的看法。
我们分析了13家不同社区药房的48项可报销吸入服务。大多数咨询涉及定量吸入器和干粉吸入器，各占42%（20/48）。我们观察到每位患者的操作错误中位数为n = 2（四分位数间距：第25百分位数为1；第75百分位数为3）。在随后的咨询中，药房工作人员平均纠正了这两个错误中的77%（95%置信区间[69%；86%]；最小值：0%；最大值：100%）。总体而言，患者对该服务的满意度非常高（总体中位数：5），而药房工作人员的满意度较高（总体中位数：4）。服务时长与未纠正的错误（r = 0.16；p = 0.35）或患者满意度（r = 0.19；p = 0.26）之间无相关性。
患者吸入技术的操作错误很常见，但在可报销吸入服务期间，大多能被药房工作人员识别并纠正。患者对该服务的满意度很高甚至非常高，而且他们通常比药房工作人员对服务更满意。
