Community Pharmacy Service for Patients With Inhaled Medications: A Multi-Perspective Observation and Assessment Under Routine Conditions.

RATIONALE

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.

AIMS

We aimed to investigate how this service is performed under routine conditions to actually achieve the proven benefits.

METHODS

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.

RESULTS

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).

CONCLUSION

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.