Bereznicki and her colleagues assessed the impact of an intervention initiated by community pharmacists, involving the provision of educational material and general practitioner (GP) referral, on asthma knowledge and self-reported asthma control and asthma-related quality of life (QOL) in patients who may have suboptimal management of their asthma, as evidenced by pharmacy dispensing records. The study was conducted at community pharmacies throughout Tasmania, Australia. Forty-two pharmacies installed a software application that mined dispensing records and generated a list of patients with suboptimal asthma management, as indicated by having three or more canisters of inhaled short-acting beta-2-agonists dispensed in the preceding 6 months. Identified patients were randomised to an intervention or control group. At baseline, intervention patients were mailed intervention packs consisting of a letter encouraging them to see their physican for a review, educational material, asthma knowledge, asthma control, and asthma-related QOL questionnaires, plus a letter with a dispensing history to give to their doctor. Pharmacists were blinded to the control patients' identities for 6 months, after which intervention patients were sent repeat questionnaires, and control patients were sent intervention packs. The main outcome measures were: (a) asthma knowledge; (b) asthma control; and (c) asthma-related QOL scores. Thirty-five pharmacies completed the study, providing 706 intervention and 427 control patients who were eligible to receive intervention packs. Intervention patients' asthma control and asthma-related QOL scores at 6 months were significantly higher compared to the control patients and to the intervention patients' baseline scores. Symptom-related QOL was significantly higher compared to the control patients and activities-related QOL significantly improved compared to baseline. No significant change was observed in asthma knowledge.

WHAT THE STUDY MAY MEAN TO YOU AS A HEALTH CARE PROVIDER: The authors concluded that the results suggest that community pharmacists are ideally placed to identify patients with suboptimal asthma management and refer such patients for a review by their GP. The type of collaborative intervention can significantly improve self-reported asthma control and asthma-related QOL in patients identified as having suboptimal management of their asthma.

WHAT THE STUDY MAY MEAN TO YOU AS A PATIENT: Feedback from your pharmacy may help you better control your asthma. The information can be easily obtained by asking whether you are obtaining regular prescriptions. However, it still becomes the responsibility of patients to not only obtain prescribed drugs, but to take them as directed. Here is where formal training in self-management could be of major value to you as a patient.

BJ Bereznicki et al. Pharmacist-initiated general practitioner referral of patients with suboptimal asthma management. Pharmacy World of Science, August 5, 2008.