Physician-Pharmacist Collaborative Management of Asthma in Primary Care

• Published in: Pharmacotherapy 2014-10, Vol.34 (10), p.1033-1042
• Main Authors: Gums, Tyler H., Carter, Barry L., Milavetz, Gary, Buys, Lucinda, Rosenkrans, Kurt, Uribe, Liz, Coffey, Christopher, MacLaughlin, Eric J., Young, Rodney B., Ables, Adrienne Z., Patel-Shori, Nima, Wisniewski, Angela
• Format: Article
• Language: English
• Subjects: Adult; asthma; Asthma - diagnosis; Asthma - therapy; Biological and medical sciences; Chronic obstructive pulmonary disease, asthma; collaboration; Cooperative Behavior; Disease Management; Female; Follow-Up Studies; Humans; Interprofessional Relations; Male; Medical sciences; Middle Aged; pharmacist; Pharmacists; Pharmacology. Drug treatments; Physician's Role; Pneumology; Primary Health Care - methods; Prospective Studies; team-based care; Young Adult
• ISSN: 0277-0008; 1875-9114
• DOI: 10.1002/phar.1468

Objective To determine if asthma control improves in patients who receive physician–pharmacist collaborative management (PPCM) during visits to primary care medical offices. Design Prospective pre–post study of patients who received the intervention in primary care offices for 9 months. The primary outcome was the sum of asthma‐related emergency department (ED) visits and hospitalizations at 9 months before, 9 months during, and 9 months after the intervention. Events were analyzed using linear mixed‐effects regression. Secondary analysis was conducted for patients with uncontrolled asthma (Asthma Control Test [ACT] less than 20). Additional secondary outcomes included the ACT, the Asthma Quality of Life Questionnaire by Marks (AQLQ‐M) scores, and medication changes. Intervention Pharmacists provided patients with an asthma self‐management plan and education and made pharmacotherapy recommendations to physicians when appropriate. Results Of 126 patients, the number of emergency department (ED) visits and/or hospitalizations decreased 30% during the intervention (p=0.052) and then returned to preenrollment levels after the intervention was discontinued (p=0.83). Secondary analysis of patients with uncontrolled asthma at baseline (ACT less than 20), showed 37 ED visits and hospitalizations before the intervention, 21 during the intervention, and 33 after the intervention was discontinued (p=0.019). ACT and AQLQ‐M scores improved during the intervention (ACT mean absolute increase of 2.11, AQLQ‐M mean absolute decrease of 4.86, p