Pharmacist-led intervention may improve patient inhaler techniques

A pharmacist-led intervention may aid in improving inhaler techniques for patients with asthma and COPD and may have a positive impact on health care resource use, according to results of a pilot study published in Respiratory Medicine.

“In recent years, community pharmacists have shifted their role in the health care system from traditional medication dispensers to health care providers,” António Teixeira Rodrigues, PharmD, PhD, researcher at the Center for Health Evaluation and Research in Lisbon, Portugal, and colleagues wrote. “Pharmacists can have a valuable role in educational interventions as they are highly accessible and have regular contact with patients, which allows them to closely monitor medicine adherence and disease management.”

The pilot, cluster-randomized, controlled INSPIRA trial included 201 adults with a self-reported asthma or COPD diagnosis from January to November 2019. All patients were on inhaled therapy treatment before study enrollment. Forty-eight pharmacies in Portugal that recruited 201 patients with asthma and/or COPD were randomly assigned to provide a pharmacist-led inhaler technique intervention (102 patients; patient mean age, 62.8 years; 66.6% women) or to no intervention (99 patients; patient mean age, 61.4 years; 64.6% women). The pharmacist-led intervention featured inhalation technique education via demonstration and repetition, as well as written and verbal counseling.

Researchers recorded follow-up data on 132 patients (average of four patients per pharmacy).

The primary outcome of the study was the proportion of patients with asthma and/or COPD who scored 100% in at least one inhaler.

At 6 months, the odds of patients in the pharmacist-led intervention group to score 100% for all inhalers used compared with the control group was 5.63 (95% CI, 2.21-14.35) and for at least one inhaler was 6.77 (95% CI, 2.52-18.2), according to the results.

Patients in the intervention group also reported a significantly lower number of scheduled physician appointments after training compared with patients in the control group (OR = 0.17; 95% CI, 0.037-0.79; P = .013).

“Public health initiatives are essential to help patients and health providers to manage these high burden diseases. Study results suggest that pharmacist-led inhaler technique educational interventions can be introduced in the pharmacy’s daily routine practice,” the researchers wrote. “Further research at national level with a larger sample size and this pilot learnings (related to intervention procedures, pharmacies and patient’s recruitment) will be needed to define the essentials of future implementation in the community pharmacy and which patients would most benefit from this intervention.”