Pharmacists Can Correct Asthma Controller Medication Underuse

Asthma controller medications are underused in neighborhoods with high rates of asthma-related emergency room use and hospitalization, but pharmacists are in a prime position to correct it.

A study published May 4, 2015 in Pediatrics analyzed data from 35,467 asthma medication prescriptions filled between January 31, 2010, and January 30, 2012, for children aged 2 to 17 years in Hamilton County, Ohio. Classifying the asthma medications as either controller or rescue, the researchers calculated a dispensing ratio for each pharmacy by dividing all dispensed controller medications by the sum of all asthma medications.

The research team found areas with pharmacies that had a lower dispensing ratio of controller medications also had a significantly higher number of asthma attacks, even after accounting for income levels and access to medical care. Additionally, pharmacies located in these areas dispensed more rescue medications than controller medications throughout the year, while the opposite was true for pharmacies in areas with fewer asthma attacks.

In an exclusive interview with Pharmacy Times, lead study author Andrew Beck, MD, explained that a number of issues at all levels of the health care system contribute to the underuse of controller medications in these communities.

“There is the potential for underprescribing on the part of physicians, who may not be seeing kids in the office,” Dr. Beck explained. For the patients themselves, there may be barriers to access or barriers to understanding the importance of the medication.”

However, Dr. Beck emphasized pharmacists’ positions in their communities and regular interactions with patients allow them to play a proactive role in correcting this underuse.

“Community-based pharmacists are very valuable extension of the health care team into neighborhoods,” Dr. Beck told Pharmacy Times. “As ‘on-the-ground’ providers, they are often closer to patients and families than physicians can be.”

Dr. Beck encouraged pharmacists to track the asthma medications of regular patients, note whether patients are picking up a proportionally low amount of controller medications compared with rescue ones, and counsel patients on the importance and benefits of both kinds of asthma medications. He also suggested that pharmacists seek ways to improve data sharing and bolster collaboration with prescribers.

“The collaboration between clinical and pharmacy settings will have major ramifications for both,” Dr. Beck said. “Pharmacy has a huge role to play in the treatment of individuals and populations, and improved communication and data sharing between all providers can greatly improve both personal and public health.”