gms | German Medical Science

11. Jahrestagung 2004 der GAA

Gesellschaft für Arzneimittelforschung und Arzneimittelepidemiologie

30.09. bis 01.10.2004, Jena

Pharmaceutical Care Services for Asthma Patients in the Region of Trier

Meeting Abstract

  • presenting/speaker S. Himstedt - Centre for Drug Information and Pharmacy Practice (ZAPP), ABDA - Federal Union of German Associations of Pharmacists
  • C. Sauerwein - Centre for Drug Information and Pharmacy Practice (ZAPP), ABDA - Federal Union of German Associations of Pharmacists
  • S. Mühlig - Technical University of Dresden
  • P. Ihle - University of Cologne
  • corresponding author I. Schubert - University of Cologne
  • M. Schulz - Centre for Drug Information and Pharmacy Practice (ZAPP), ABDA - Federal Union of German Associations of Pharmacists

Gesellschaft für Arzneimittelanwendungsforschung und Arzneimittelepidemiologie (GAA) e.V.. 11. Jahrestagung der Gesellschaft für Arzneimittelforschung und Arzneimittelepidemiologie (GAA) e.V.. Jena, 30.09.-01.10.2004. Düsseldorf, Köln: German Medical Science; 2004. Doc04gaa31

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/gaa2004/04gaa31.shtml

Veröffentlicht: 30. September 2004

© 2004 Himstedt et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Background and Objective

Asthma is still one of the major health problems in industrialized countries. Although new drugs and evidence-based guidelines have been developed, no major change in morbidity and mortality can be recognized. After proving efficacy [1], the aim of this intervention study was to evaluate the effectiveness of pharmaceutical care with regard to clinical, humanistic, and economic outcomes in adult asthma patients.

Design

Intervention study over 12 months. Pre-post-design with repeated measurements at 6 and 12 months. At baseline, 39 community pharmacies and 183 patients (age 18-65 years) diagnosed with asthma. 33 pharmacies (85 %) with a total of 128 patients (70 %) completed the study. In co-operation with the physician in attendance, five meetings between pharmacists and patients were scheduled (baseline, and at 2, 4, 6, 12 months).

Setting

All of the 148 community pharmacies in the region of Trier (Rhineland-Palatino) were invited to enter the study. 57 of them agreed to participate. At last, 39 pharmacies recruited patients and offered pharmaceutical care.

Main Outcome Measures

Clinical (lung function, asthma severity, symptoms, peak expiratory flow rate), humanistic (knowledge, asthma-specific quality of life, self-efficacy, compliance), inhalation technique, and economic parameters (hospital admissions, absence from work, and drug consumption). To evaluate economic outcomes, two big German statutory health-insurance companies provided 2-years' claims data for their insured patients (n=55) for the 1-year-period before the study and for the study year. A 1:10 matching was carried out to compare the results of the intervention group to a non-intervention group (sick fund data in a different state).

Matching factors were gender, age, date of recruitment, and amount (DDD) of prescribed anti-asthmatics (ATC: R03).

Results

Significant improvements could be established concerning all humanistic outcomes (e.g., knowledge, quality of life, self efficacy, compliance). In addition, the patients' self reported symptoms, peak expiratory flow (p<0.001) and asthma severity (p= 0.002) improved. Increases in lung function (FEV1 and vital capacity) were not significant over time (pFEV 1 = 0.484 and pvc= 0.256). Evaluation of the claims data showed that, in comparison to the control group the number of recipients of long-acting β2-agonists and of inhaled steroids increased. Concurrently, a decrease in prescribed short-acting β2-agonists could be observed. Low overall asthma severity at/before baseline and the small number of patients for whom health-economic data were available did not allow further analysis of economic outcomes.

Conclusions

Pharmaceutical care for asthma patients has a clear positive impact on humanistic and to some extent on clinical outcomes. Especially, factors vulnerable to patients' self-management improved. In co-operation with the prescriber, drug therapy changed towards evidence-based guidelines. Family pharmacy contracts with health insurance funds provides remuneration for these services. To evaluate potential economic benefits, future research may focus on patients with more severe or uncontrolled asthma e.g., a significant number of hospitalisations.

Funding: The study was supported by ABDA.

Conflict of interest: None declared.


References

1.
Schulz M et al. J Clin Pharmacol 2001